Who We Are

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. To learn more about who we are at Point32Health, click here.

Job Summary

Reporting to the EVP, Chief Operations Officer, the Senior Vice President of Operations (SVP) is a strategic operator and member of the senior leadership team. S/he is responsible for driving operational excellence culturally and through back-office automation, leveraging evolved automations and technology for advancing the priorities of the company. The SVP evolves Operations to be a strategic enabler for the organization by continual identification of improvement, digitization, and automation opportunities, resulting in annual operating efficiency increases year-over-year. The SVP enables growth, retention, and line of business performance through end-to-end process accountability, back-office automation, quality, controls, and synergy alignment amongst business operations across Point32Health. This leader will partner with the COO and other executive leaders to develop strategies that shape the company’s strategic direction, achieve the company’s performance goals, and ensure delivery of an exceptional experience for health plan members.

The SVP is the leader accountable for flexible, effective, and efficient health plan operations including, claims intake and processing; coordination of benefits, liability, and recovery programs; provider and member enrollment; plan and benefit configuration; business controls; and quality assurance.

Key Responsibilities/Duties – what you will be doing

Ensures that all departments meet service level agreements, quality standards, and performance goals based on the development and monitoring of cost and process metrics; including KPIs focused on efficiency, effectiveness, and resilience.
Enable growth, retention and line of business performance through operational enablement, such as end to end process, back-office automations, quality and controls, and greater synergies across and amongst business operations across Point32Health
Empower, build, and generate enthusiasm amongst all Point32Health colleagues for the Operational excellence agenda. Build high-performing teams, drive employee engagement, curate talent, and focus on diversity, equity, and inclusion as cornerstones to success.
Manage a complex, multi-faceted administrative budget for high-performance results and administrative simplicity year-over-year
Evolve the continuous improvement culture to constantly act by leading a cross-functional committee to predict, anticipate and plan for demand from line of business needs, and to proactively manage fixes/inertia within operational processes that have redundancy and/or lack of scale
Anticipate and scale business controls, regulatory requirements, and compliance activities for improved readiness and responsiveness, performance and to gain advantage
Through business planning and strong partnership, showcase the importance of operations within the organization and create career development paths that prevent top talent from leaving.
Develop a plan and sequence for digitization and automation of back-office policies, procedures and processes for scale, efficiency, effectiveness and improved customer experience
Provide Real-time transparency into operational performance, reporting and course correction
Ensure readiness and resilience in business controls and quality programs
Plans and participates in large administrative system implementations and the development of comprehensive, efficient operational readiness programs

Integration of operational teams across organizations as company strategy requires
Advocates for the desired culture in high-level planning and decision-making, with a focus on performance accountability and achieving greater operational efficiencies
Develops, leads, and manages a diverse team ensuring that succession and development plans are in place to achieve the company’s goals and to develop talent
Applies current knowledge and understanding of regulations, industry trends, current best practices, new developments, and applicable laws to ensure operational and financial effectiveness. Partners to ensure regulatory compliance for all areas of responsibility
Acts as a key participant in the strategic and long-range planning of the organization. Integrates long-range plans with operational plans and capital priorities
Aligns market-facing activities and back-office resources to meet the specific needs of the three lines of business, including Commercial, Medicare and Medicaid

Qualifications – what you need to perform the job

EDUCATION, CERTIFICATION AND LICENSURE:

Bachelor’s degree required

EXPERIENCE (minimum years required):

15 years in a senior operations leadership role, preferably in the healthcare sector
Strong leadership skills with experience managing multidisciplinary teams in a complex organizational structure
Extensive experience planning and managing large-scale operations teams and initiatives (including capital planning, across matrixed organizations)
Demonstrated strong executive presence and success as a collaborative leader with experience attracting, developing managing, motivating and retaining outstanding talent

SKILL REQUIREMENTS:

The ability to create and articulate an inspiring vision for the organization, not only for the areas s/he is directly responsible for, but the enterprise as a whole.
The inclination to seek and analyze data from a variety of sources to support decisions and to align others with the organization's overall strategy.
An entrepreneurial and creative approach to developing new, innovative ideas that will stretch the organization and push the boundaries within the industry.
The ability to effectively balance the desire/need for broad change with an understanding of how much change the organization is capable of handling, to create realistic goals and implementation plans that are achievable and successful.
The ability to set clear and challenging goals while committing the organization to improved performance; tenacious and accountable in driving results.
Comfortable with ambiguity and uncertainty; the ability to adapt nimbly and lead others through complex situations.
A risk-taker who seeks data and input from others to foresee possible threats or unintended circumstances from decisions; someone who takes smart risks.
A leader who is viewed by others as having a high degree of integrity and forethought in his/her approach to making decisions; the ability to act in a transparent and consistent manner while always taking into account what is best for the organization.
The ability to attract and recruit top talent, motivate the team, delegate effectively, celebrate diversity within the team, and manage performance; widely viewed as a strong developer of others.
The ability to persevere in the face of challenges and exhibit a steadfast resolve and relentless commitment to higher standards, which commands respect from followers.
A leader who is self-reflective and aware of his/her own limitations; leads by example and drives the organization's performance with an attitude of continuous improvement by being open to feedback and self-improvement.
Naturally connects and builds strong relationships with others, demonstrating strong emotional intelligence and an ability to communicate clearly and persuasively.
An ability to inspire trust and followership in others through compelling influence, powerful charisma, passion in his/her beliefs, and active drive.
Encourages others to share the spotlight and visibly celebrates and supports the success of the team.
Creates a sense of purpose/meaning for the team that generates followership beyond his/her own personality and engages others to the greater purpose for the organization

WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS (include special requirements, e.g., lifting, travel):

Must be able to work under normal office conditions and work from home as required.
Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
May be required to work additional hours beyond standard work schedule.

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.

Compensation & Total Rewards Overview

As part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company’s sole discretion, consistent with the law.

Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:

Medical, dental and vision coverage
Retirement plans
Paid time off
Employer-paid life and disability insurance with additional buy-up coverage options
Tuition program
Well-being benefits
Full suite of benefits to support career development, individual & family health, and financial health

For more details on our total rewards programs, visit https://www.point32health.org/careers/benefits/

Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity

Point32Health is committed to making diversity, equity, inclusion, accessibility and health equity part of everything we do—from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity team's strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.