OverviewResponsibilities
Develop and execute the financial and operational strategy for the employee health plan, aligning with organizational goals and value-based care objectives.
Own portfolio performance reporting, budget coordination, and KPI dashboards for senior leadership.
Ensure all segments operate within a consistent, accountable, and audit-ready performance framework.
Lead performance improvement initiatives, including Lean/Six Sigma, DMAIC, and value-stream mapping for core processes.
Monitor and optimize budget performance, identify cost-saving opportunities, and recommend operational efficiencies.
Conduct financial analyses to identify areas for cost and quality interventions.
Partner with Finance to validate financial results and ensure compliance with fiscal policies.
Oversee operational processes to improve efficiency, quality, and service delivery.
Identify process inefficiencies, implement improvements, and sustain gains across health plan functions.
Lead cross-functional teams (EHP, Finance, Operations, Technology, Compliance, HR) to integrate quality and process improvement into strategic plans.
Serve as the primary liaison between senior leadership, operational teams, and external partners (e.g., TPA, ASO and vendors).
Provide consultative support to leadership and plan executives on performance, compliance, and strategic initiatives.
Lead, develop, and coach managers and senior staff, fostering a culture of accountability, growth, and continuous improvement.
Manage staff capacity, bandwidth optimization, and employee development aligned with organizational priorities.
Ensure adherence to regulatory requirements and internal policies.
Identify and mitigate operational, financial, and compliance risks
Qualifications
Bachelor’s degree in finance, business, healthcare administration, or related field.
12+ years in health plan contracting, payer relations, healthcare strategy, or operational management; 6–8 years in leadership.
Proven expertise in financial performance, operational excellence, and continuous improvement.
Strong analytical, problem-solving, and communication skills; ability to influence without direct authority.
Pay Transparency
Prime Healthcare offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. Benefits may vary based on employment status, i.e. full-time, part-time, per diem or temporary. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $108,700.80 to $163,030.40 on an annualized basis. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.
Employment StatusFull Time
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