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Vice President, Managed Care Operations Jobs

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Explore high-impact Vice President, Managed Care Operations jobs and discover a pivotal executive career at the intersection of healthcare strategy, finance, and delivery. Professionals in this senior leadership role are responsible for architecting and executing the operational and financial strategies that connect healthcare providers with insurance payers. Their core mission is to optimize the performance of value-based and risk-bearing contracts, ensuring both financial sustainability and the delivery of high-quality patient care. This position is critical for organizations navigating the complex landscape of managed care, making these jobs central to the modern healthcare ecosystem. Typically, a Vice President of Managed Care Operations holds enterprise-wide accountability for payer relationships and contract performance. Common responsibilities include developing and leading the national strategy for payer contracting, with a deep focus on innovative value-based care models such as full-risk capitation arrangements. They oversee the entire contract lifecycle, from negotiation and design through implementation, monitoring, and reconciliation. A significant part of the role involves establishing governance frameworks, policies, and procedures to ensure regional and clinical teams can successfully operationalize contract terms. These leaders are also tasked with analyzing complex financial and clinical data to monitor contract performance, identify trends, and communicate risk insights to the C-suite and board. Building and mentoring a high-performing team responsible for contracting, credentialing, and provider data management is another fundamental duty. The typical skill set for these executive jobs is extensive. Candidates generally possess 10-15+ years of progressive experience in healthcare, with deep expertise in managed care contracting, medical economics, and payer-provider partnerships. A strong financial acumen and the ability to understand the levers within risk-based arrangements are non-negotiable. Essential skills include strategic thinking, executive presence, and superior stakeholder management to foster collaborative relationships with health plan leaders. Proficiency in analytics, root cause analysis, and the use of dashboards for performance reporting is crucial. Knowledge of regulatory environments like Medicare Advantage and CMS innovation models is standard, as is familiarity with credentialing compliance and provider data interoperability strategies. Success in this profession requires a leader who can thrive in a matrixed organization, drive continuous process improvement, and align cross-functional teams—including finance, clinical operations, and legal—toward common strategic goals. For those seeking to shape the future of healthcare finance and delivery, Vice President, Managed Care Operations jobs offer a challenging and rewarding career path at the highest level.

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