The Vice President, Operational Excellence is responsible for leading enterprise transformation initiatives that drive operational excellence, organizational performance, and strategic execution across the Medicare Advantage health plan. Reporting to a senior executive leader, this role serves as a key member of the leadership team and is accountable for establishing and advancing the organization's transformation agenda, strategic planning processes, capital investment governance, process improvement programs, and enterprise roadmap development.

The Vice President partners closely with executive leadership to translate strategic priorities into actionable initiatives, oversee enterprise portfolios, optimize business operations, and ensure investments deliver measurable value. This role leads cross-functional transformation efforts spanning operations, clinical services, technology, quality, and provider and member experience.

The successful candidate combines strategic thinking, operational leadership, financial acumen, and change management expertise to drive meaningful improvements in organizational performance, member outcomes, and regulatory readiness.

Job Responsibilities:

Enterprise Transformation Leadership

• Develop and execute the organization's enterprise transformation strategy aligned with long-term business objectives.

• Lead large-scale transformation programs that improve operational efficiency, enhance member and provider experiences, and support organizational growth.

• Identify strategic opportunities to improve performance, reduce costs, increase scalability, and strengthen competitive positioning.

• Serve as an executive sponsor for high-priority enterprise initiatives.

• Foster a culture of continuous improvement, innovation, accountability, and execution excellence.

Strategic Planning & Enterprise Execution

• Lead the annual and multi-year strategic planning process.

• Partner with executive leadership to define strategic priorities, growth objectives, and organizational performance targets.

• Translate strategic goals into actionable business initiatives and measurable outcomes.

• Facilitate strategy development sessions, executive planning retreats, and enterprise prioritization discussions.

• Establish mechanisms to monitor and report progress against strategic objectives.

Capital Planning & Investment Governance

• Lead enterprise capital planning and strategic investment management processes.

• Establish governance frameworks for evaluating, prioritizing, and approving strategic initiatives and capital investments.

• Oversee development of business cases, financial analyses, ROI assessments, and investment recommendations.

• Partner with Finance and executive leadership to align capital allocation with enterprise priorities.

• Monitor realization of expected benefits and value delivered from approved investments.

• Chair or support investment review committees and strategic governance forums.

Enterprise Portfolio & Roadmap Development

• Develop and maintain enterprise transformation roadmaps aligned with organizational strategy.

• Oversee the portfolio of strategic initiatives, ensuring alignment with business objectives and resource capacity.

• Establish portfolio management practices that balance growth, regulatory, operational, and technology priorities.

• Ensure dependencies, risks, milestones, and resource requirements are managed effectively.

• Drive enterprise transparency through portfolio reporting and executive dashboards.

Process Improvement & Operational Excellence

• Lead the organization's process improvement and operational excellence programs.

• Establish and implement Lean, Six Sigma, and continuous improvement methodologies.

• Identify opportunities to streamline workflows, eliminate waste, improve productivity, and enhance service quality.

• Collaborate with operational leaders to redesign core business processes.

Total Cost of Care Transformation & Value Optimization

• Partner with Clinical, Network, Population Health, Actuarial, Finance, Pharmacy, and Operations leadership to develop and execute enterprise Total Cost of Care (TCOC) strategies.

• Identify and prioritize strategic initiatives that improve health outcomes while reducing medical cost trends and unnecessary utilization.

• Establish governance processes to evaluate, prioritize, and monitor TCOC improvement initiatives across the organization.

• Collaborate with Finance and Actuarial teams to quantify financial impact, projected savings, ROI, and value realization for cost-of-care initiatives.

• Develop enterprise roadmaps designed to improve medical loss ratio (MLR), reduce avoidable utilization, and enhance quality outcomes.

Business Transformation & Change Management

• Lead organizational change efforts required to execute strategic initiatives successfully.

• Develop frameworks for adoption, stakeholder engagement, communication, and organizational readiness.

• Ensure sustainable implementation of new business processes, technologies, and operating models.

• Build leadership alignment around transformational priorities.

• Mitigate organizational resistance and implementation risks.

Executive Leadership & Governance

• Lead executive governance processes supporting strategic initiatives and transformation programs.

• Develop executive-level reporting and performance dashboards.

• Present recommendations, investment proposals, and progress updates to senior leadership and Board committees.

• Drive enterprise accountability for achieving strategic objectives.

Team Leadership & Organizational Development

• Build and lead a high-performing team responsible for strategy execution, program management, process improvement, business analysis, and transformation delivery.

• Mentor and develop leaders across transformation and operational excellence functions.

• Foster a collaborative, accountable, and results-oriented culture.

• Establish best practices in strategic planning, portfolio management, and process improvement.

Job Requirements:

Experience:

Required:

• 10+ years of progressive leadership experience in healthcare, managed care, consulting, transformation, strategy, operations, or program management.

• 5+ years of executive or senior leadership experience overseeing enterprise initiatives and large-scale business transformation.

Education:

Required:

• Bachelor's degree in Business Administration, Healthcare Administration, Finance, Supply Chain, Public Health, or related field.

Specialized Skills:

Required:

• Demonstrated success leading strategic planning, transformation, and process improvement programs.

• Experience managing enterprise portfolios and complex cross-functional initiatives.

• Strong financial acumen, including business case development, capital planning, and investment evaluation.

• Exceptional executive communication, stakeholder management, and leadership skills.

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.

2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Pay Range: $227,952.00 - $341,928.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.