VP, Member Operations - #1405503

We exist for workers and their employers -- who are the backbone of our economy. That is where Centivo comes in -- our mission is to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills.

Summary of Role:

The VP, Member Operations position combines operational experience with process orientation and strong leadership capabilities to simultaneously champion both operational excellence and organizational success over Member/Provider Care/Call Center, Care Management, Client/Member Issue Resolution, and Open Enrollment and New Member Acquisition. This role has responsibility for delivery and execution, tracking, course-correcting, and reporting on relevant operational metrics while managing operational spend in their area.

Duties & Responsibilities:

• Provide coaching and mentorship to department leads and develop talent within the department
• Partner with Finance and executive leadership to manage budgets, assess ROI, and align operational investments with business goals
• Collaborate with internal stakeholders including Product, Technology, Network, Implementation and Clinical to ensure seamless operations and member experience
• Participate in enterprise-level strategy sessions to inform Centivo’s go-forward service model and scalability roadmap
• Provide departmental leadership and operational oversight in assigned third-party medical benefits administration departments
• Develop and implement operational strategies, policies, and procedures to ensure efficient, high-quality service delivery and regulatory compliance
• Lead operational improvement initiatives, including performance management, process automation, and cost reduction efforts
• Monitor and report on key performance indicators, operational metrics, vendor performance and quality standards to drive continuous improvement
• Collaborate with executive leadership and cross-functional teams to align operational goals with broader business objectives
• Manage audits, corrective action plans, and ensure adherence to internal and external regulatory requirements
• Oversee budgeting, resource allocation, and vendor contract negotiations
• Foster a culture of accountability and execution rigor within assigned departments
• Provide performance management, coaching, and development of team members by modeling Centivo’s leadership skills and behaviors
  
  

Qualifications:

• Bachelor’s degree required; advanced degree in appropriate discipline preferred
• 7 years of experience at a third-party administrator, regional or national health plan
• 5 years of experience in an operations role of significant scope
• 5 years of proven leadership experience managing, leading, and coaching teams
• Deep knowledge of self-funded health plans and compliance in the healthcare payer space
• Demonstrated experience leading at least 2 of the operational departments within the scope and proven aptitude and strong interest in leading the others
• Deep expertise in scaling and efficiency in Call Center operations is strongly preferred
• Demonstrated ability to drive operational improvement and communicate operational needs to internal product teams
• Strong ability to build consensus among stakeholders and cross-functional teams in a dynamic environment
• Familiarity with process management and continuous improvement principles
  
  

Leadership Skills:

Business Acumen – A keenness and quickness in understanding and dealing with a business situation (risks and opportunities) in a manner that is likely to lead to a good outcome.  Critical to this is an ability to think beyond their own function.

Accountability & Execution – Taking ownership of actions, following through on commitments, actively carrying out tasks, monitoring progress, delivering results as promised, and being answerable for positive and negative outcomes.

Strategist Mindset - The ability see and articulate the bigger picture, thinking proactively and anticipating both opportunities and obstacles in the context of setting direction and maintain alignment to long-term company goals.

Systems Thinking – The ability to see and articulate the patterns, interconnections and interdependencies within a system

Process Orientation – The ability to see and articulate the sequential flow of activities, including anticipating impacts upstream and downstream when processes are changed.

Flexibility/Working through Ambiguity – Tendency to be energized by new experiences/perspectives, working with both data and fragmented information to arrive at practical, effective, actionable next steps.

Leadership Behaviors:

Communicate – Managers discuss the company’s vision and strategies, the department’s direction and goals, and in times of crisis, what we know and don’t know to make sure team members know what they need to know.

Clarify – As managers, it’s up to us to clarify what good looks like. What do we expect? What do our clients, customers or colleagues need? If our teams are not performing as expected, managers must clarify expectations and ensure understanding.

Coach – Managers provide recognition and feedback; help team members find solutions to challenges; amplify good and filter weaker aspects of organizational culture and the work as they coach employees in their day-to-day performance and their growth and career development.

Connect – Managers help our teams see their collective purpose and how their work connects to the greater whole. We connect people within our company and network.

Centivo Values:

Resilient – This is wicked hard. There is no easy button for healthcare affordability. Luckily, the mission makes it worth it and sustains us when things are tough. Being resilient ensures we don’t give up.

Uncommon - The status quo stinks so we had to go out and build something better. We know the healthcare system. It isn't working for members, employers, and providers. So we're building it from scratch, from the ground up. Our focus is on making things better for them while also improving clinical results - which is bold and uncommon.

Positive – We care about each other. It takes energy to do hard stuff, build something better and to be resilient and unconventional while doing it. Because of that, we make sure we give kudos freely and feedback with care. When our tank gets low, a team member is there to be a source of new energy. We celebrate together. We are supportive, generous, humble, and positive. 

Work Location:

• Buffalo based with in-office expectations
  
  

Who we are:

Centivo is an innovative health plan for self-funded employers on a mission to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills. Anchored around a primary care based ACO model, Centivo saves employers 15 to 30 percent compared to traditional insurance carriers. Employees also realize significant savings through our free primary care (including virtual), predictable copay and no-deductible benefit plan design. Centivo works with employers ranging in size from 51 employees to Fortune 500 companies. For more information, visit centivo.com.

Headquartered in Buffalo, NY with offices in New York City and Buffalo, Centivo is backed by leading healthcare and technology investors, including a recent round of investment from Morgan Health, a business unit of JPMorgan Chase & Co.

Compensation Range: $180K - $200K