Key Responsibilities:

Clinical & Operational Leadership

• Serves as the primary operational partner to Clinical Leadership to ensure alignment between business operations and clinical strategy.
• Collaborates with Clinical Leadership to establish enterprise priorities, strategic initiatives, and operational plans that improve member outcomes and financial performance.
• Shares accountability for enterprise P&L performance, including membership growth, medical expense management, risk adjustment performance, quality outcomes, and operating margin.
• Partners with Clinical Leadership to develop and execute value-based care strategies that enhance quality, member experience, provider engagement, and cost efficiency.
• Ensures operational infrastructure, workflows, analytics, and resources effectively support clinical programs and care delivery models.
• Collaborates on market performance reviews, identifying opportunities to improve operational, clinical, quality, and financial outcomes.
• Aligns operational and clinical leadership teams around shared goals, performance expectations, and organizational priorities.
• Facilitates resolution of cross-functional issues and promotes coordinated decision-making across operational and clinical teams.
• Partners with Clinical Leadership in evaluating new clinical programs, service models, pilots, and strategic growth opportunities.

Enterprise Operations Leadership

• Provides executive leadership and strategic direction for all operational functions across the organization.
• Develops and executes operating strategies that support organizational growth, profitability, quality performance, member experience, and value-based care objectives.
• Aligns people, processes, technology, and resources to achieve enterprise goals and operational excellence.
• Establishes performance metrics, accountability structures, and governance processes to ensure consistent execution across all operating areas.
• Creates scalable operational models that support growth while maintaining efficiency, compliance, and service excellence.
• Leads cross-functional collaboration among Clinical, Finance, Technology, Compliance, Quality, and Market leadership teams.
• Partners with Clinical Leadership to ensure business operations support clinical excellence, quality improvement, and population health objectives.
• Establishes joint operational and clinical performance goals and accountability measures.
• Ensures operational decisions appropriately balance member outcomes, provider experience, regulatory requirements, and financial performance.

Membership (Growth, Markets, Sales & Implementation)

• Oversees the organization's membership strategy, including growth, sales performance, market operations, implementations, and expansion initiatives, all in compliant fashion.
• Ensures successful launch, integration, transition, and operational readiness for new markets, partnerships, and products.
• Drives sustainable membership growth through strong market execution and partner engagement strategies.
• Provides oversight of market performance and develops action plans to improve operational, financial, quality, and membership outcomes.
• Ensures consistency in operational standards, member experience, and performance expectations while allowing markets flexibility to address local healthcare dynamics and provider relationships.
• Strengthens relationships with Skilled Nursing Facility (SNF) partners, ownership groups, and regional healthcare stakeholders.

Network Management

• Provides executive oversight of provider and facility network strategy, contracting, performance, and optimization.
• Ensures development of high-performing provider and facility networks that support quality outcomes, member access, and financial objectives.
• Oversees network growth, provider engagement, and strategic partnerships across all markets.
• Ensures provider contracting strategies support organizational goals, value-based care objectives, risk arrangements, and market expansion plans.
• Partners with Clinical and Quality leadership to improve provider performance and care delivery outcomes.

Health Plan Operations

• Oversees all health plan operational functions, including enrollment, eligibility, member services, claims administration, appeals and grievances, configuration, operational readiness, and delegated operations (vendor performance and accountability).
• Ensures operational compliance with CMS, state regulatory agencies, and contractual requirements.
• Drives service excellence and operational efficiency through process optimization and continuous improvement initiatives.
• Establishes performance standards and service-level expectations to ensure superior member and provider experiences.
• Monitors operational performance metrics and implements corrective actions as necessary.

Business Enablement

• Leads enterprise business enablement functions that support organizational effectiveness, scalability, and execution.
• Ensures operational infrastructure, business processes, project management, reporting, analytics, and technology solutions effectively support strategic priorities.
• Sponsors enterprise transformation and process improvement initiatives.
• Promotes operational standardization, workflow optimization, and automation opportunities.
• Oversees governance structures that improve prioritization, resource allocation, accountability, and cross-functional execution.

IPA Operations

• Provides strategic and operational oversight of IPA development, growth, and performance.
• Ensures alignment between IPA strategy, organizational value-based care objectives and partners of IPA business.
• Oversees financial, operational, quality, and compliance performance of IPA operations.
• Partners with Clinical and Network leadership to improve provider engagement, care coordination, population health outcomes, and risk performance.

Strategic Leadership

• Partners with the CEO and Executive Leadership Team to identify opportunities for growth, innovation, operational improvement, and organizational effectiveness.
• Leads enterprise operational planning efforts and ensures successful execution of strategic priorities.
• Provides executive-level visibility into operational performance through dashboards, governance reviews, and reporting structures.
• Builds organizational alignment, resolves cross-functional barriers, and drives accountability for results.
• Promotes a culture of collaboration, innovation, transparency, accountability, and continuous improvement.

Financial & Performance Management

• Shares accountability with Clinical Leadership for enterprise P&L performance and achievement of organizational financial objectives.
• Leads the operational drivers of financial performance, including membership growth, implementation effectiveness, market execution, administrative efficiency, network optimization, and operational scalability.
• Partners with Clinical Leadership to improve medical cost performance, quality outcomes, risk adjustment accuracy, utilization management effectiveness, and value-based care results.
• Oversees operational budgeting, forecasting, workforce planning, and resource allocation activities.
• Monitors enterprise performance metrics and drives corrective actions when operational or financial performance deviates from established goals.
• Ensures organizational resources are deployed effectively to support sustainable growth and long-term profitability.

Leadership & Culture

• Leads a culture of professionalism, accountability, service excellence, and high performance.
• Recruits, develops, mentors, and retains high-performing leaders and teams.
• Promotes collaboration across departments and markets.
• Establishes succession planning and leadership development strategies.
• Models Longevity's mission, values, and leadership expectations.
• Performs other duties as assigned.
• Performs other related duties as assigned.

Supervisory Responsibilities:

• Accomplishes organizational objectives through effective leadership and management of assigned departments.
• Recruits, selects, develops, and retains high-performing team members.
• Provides coaching, mentoring, and performance management.
• Establishes clear expectations and accountability measures.
• Conducts performance evaluations and succession planning activities.
• Implements and enforces organizational policies and procedures.
• Ensures efficient utilization of organizational resources.
• Oversees departmental budgets and financial performance.
• Fosters employee engagement and professional development.
• Contributes to team effort by accomplishing related results as needed.

Licensure & Certification:

• Valid state driver’s license with a good driving record and proof of automobile insurance per minimum required by home state.
• Auto insurance coverage as required by your state of residence.
• New employees will be responsible for providing proof of coverage prior to hire and on an ongoing basis.

Education & Training:

• Bachelor's degree required.
• Master's degree in Healthcare Administration, Business Administration, Public Health, Finance, or related field preferred.

Knowledge & Experience:

• 15+ years of progressive healthcare leadership experience, including significant executive-level operational oversight.
• Experience leading complex, multi-state healthcare operations.
• Demonstrated success in Medicare Advantage, value-based care, managed care, provider networks, IPA operations, or related healthcare environments.
• Strong understanding of health plan operations , provider contracting, risk-based reimbursement, and population health strategies.
• Experience leading large-scale operational transformations and growth initiatives.
• Proven ability to balance strategic vision with operational execution.
• Strong financial acumen with experience managing budgets, operational performance, and profitability.
• Exceptional leadership, communication, relationship management, and change management skills.
• Ability to influence and collaborate across executive leadership, provider organizations, and external partners.
• High level of organizational, analytical, and problem-solving capability.
• Proficiency in Microsoft Office and healthcare business applications.