VP, Member & Provider Support Center Services

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a VP, Member & Provider Support Center Services based in United States.

This executive leadership role is responsible for shaping the strategy and operational performance of large-scale member and provider support center services. You will oversee a complex, multi-market function supporting Medicaid, Medicare, and Marketplace lines of business. The role combines operational leadership, workforce strategy, financial accountability, vendor management, quality assurance, and customer experience. You will drive initiatives that improve service quality, increase satisfaction, strengthen compliance, and reduce administrative costs. Working across a highly matrixed organization, you will influence senior stakeholders and lead transformation across people, processes, technology, and service delivery. This is an opportunity to make a significant enterprise-wide impact while helping deliver better experiences for members and providers.

• Provide executive-level strategy, vision, and direction for member and provider support center services, maintaining accountability for operational performance, financial results, and strategic outcomes.
• Lead support center operations across Medicaid, Medicare, and Marketplace lines of business, including workforce management, reporting, quality assurance, business solutions, telephony, and vendor performance.
• Develop and execute strategies that strengthen operational excellence, support business growth, and improve member and provider satisfaction, retention, and service quality.
• Build and maintain strong relationships with senior internal and external stakeholders to ensure consistent and effective shared-service delivery across the organization.
• Lead the integration of newly acquired employees, teams, and scopes of work while ensuring appropriate organizational structures and operating models.
• Identify and lead initiatives that reduce administrative costs, improve productivity, increase automation, and deliver more efficient support center operations.
• Convene cross-functional work groups, establish implementation plans, assign responsibilities and timelines, and measure outcomes against defined objectives.
• Lead direct employees and oversee external vendors, establishing clear performance expectations and accountability for service quality, cost, compliance, and operational results.
• Ensure state, federal, contractual, and organizational policies, procedures, and standard operating procedures are consistently implemented across the support center function.
• Develop and manage departmental budgets, monitor costs, identify efficiency opportunities, and continuously seek ways to reduce unit costs and overall administrative expenses.
• Design and implement systematic approaches to improve member and provider experiences through greater operational efficiency and effectiveness.
• Identify and communicate potential financial liabilities, risks, and accrual requirements to senior leadership.
• Recruit, develop, coach, and retain high-performing teams while establishing clear goals, accountability, and professional development opportunities.
• Champion a dynamic leadership culture focused on delivering high-quality healthcare and exceptional service to underserved populations.

Requirements

• 12+ years of healthcare operations and/or contact center experience, including experience managing large, matrixed teams, or an equivalent combination of relevant education and experience.
• At least 7 years of management or executive leadership experience.
• Demonstrated experience leading operations across multiple markets and product lines.
• Strong knowledge of customer experience, workforce management, data analytics, quality metrics, and operational performance management.
• Experience developing, managing, and optimizing departmental budgets within defined financial parameters.
• Proven experience managing account relationships and partnering with senior-level leadership and external stakeholders.
• Understanding of Medicare, Medicaid, and Marketplace health plans.
• Experience with Genesys, Salesforce, or comparable contact center and customer relationship management platforms.
• Demonstrated ability to influence peers and organizational leaders, drive change, and build consensus around strategic initiatives.
• Ability to envision future-state processes and systems, develop business proposals, obtain stakeholder alignment, and lead implementation.
• Strong adaptability and flexibility, with the ability to respond effectively to evolving business priorities, new ideas, and changing operating environments.
• Excellent organizational and time-management skills, with the ability to manage multiple complex initiatives simultaneously and meet critical deadlines.
• Strong relationship-building skills and the ability to collaborate effectively across a highly matrixed organization.
• Excellent written and verbal communication skills, with the ability to communicate effectively with executives, employees, vendors, clients, members, and providers.
• Proficiency with Microsoft Office, including Excel, and other relevant business and operational software.
• Experience implementing process improvements within a matrixed organization is preferred.
• Managed care experience is preferred.

Benefits

• Competitive compensation package.
• Comprehensive employee benefits package.
• Opportunity to lead a large-scale, enterprise-wide support center function across multiple healthcare markets and product lines.
• Executive-level visibility and influence over operational strategy, financial performance, customer experience, and transformation initiatives.
• Opportunity to drive automation, process improvement, and innovative solutions across complex healthcare operations.
• Leadership opportunity spanning internal teams, external vendors, workforce management, quality, analytics, and technology.
• Professional growth and development opportunities within a large healthcare organization.

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

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