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Vice President, Eligibility & Payment Operations

Collective Health

Collective Health

Plano, TX, USA
Posted on Tuesday, February 27, 2024

We all depend on healthcare throughout our lifetimes, for ourselves, and our families and friends, but it is notoriously difficult to navigate and understand. As an industry that comprises 20% of the US economy we think healthcare should work better for all of us. At Collective Health we believe it’s time for a new day in healthcare where as members we are informed and empowered to make the right care choices when the decisions are urgent and critical.

Collective Health is the first integrated solution that allows self-funded employers to administer plans, manage costs, and take care of their people—all in one place. We replace a disjointed experience with one connected system to drive more value from your total healthcare investment. Collective Health streamlines client’s day-to-day activity in eligibility and Card Operations in one integrated experience.

Eligibility is one of the highest-priority enterprise processes and is at the center of both plan administration and Collective Health’s value proposition.

As the VP Eligibility & Card Operations you will report into our Chief Customer Experience Officer and lead the operations teams responsible for Eligibility and ID Cards. We’re on an undeniable growth path and looking for a senior leader to help us continue to raise the bar on enabling modern healthcare.

This role is responsible for the development, scaling, and execution of the Eligibility and Card Operations capabilities, focused on simplifying end-to-end customer experiences and business processes in a scalable way, while reducing operational expenses and risks.

What you’ll do:

  • Evaluate Collective Health’s role in Health Benefits & Non-medical Eligibility and build the next generation of eligibility at Collective Health
    • Drive innovation in Eligibility to better serve our clients/members and reduce our cost to deliver our differentiated service partnering with Product and Engineering
    • Build a plan that balances the needs of our clients, unique positioning of our product strategy, and long-term value Collective Health can deliver
    • Identify both near-term and long-term strategic opportunities that span customer experience, operational processes, technology, automation, and risk management
    • Drive execution against strategic priorities with urgency, prioritize and sequence strategic transformation of Eligibility to realize opportunities identified, pivoting as needed.
    • Partner with Product and Engineering leadership to execute short and long term strategies enabled by technology
    • Develop and deliver success measurements and sustainability plans
    • Develop and execute an organization-wide change management plan with your own team, with key stakeholders, and across the organization
    • Lead broad, multidisciplinary stakeholder management
  • Lead the Collective Health Eligibility and Card Operations teams
    • Responsible for leading daily operations
    • Ensure proper governance structure exists for the delivery lifecycle for eligibly integrations
    • Oversee the daily receipt and processing of eligibility files with partners including the process for troubleshooting and resolving daily processing edits
    • Accountable for driving results that meet performance KPIs
    • Lead resolution and drive blameless root cause analysis and improvements
    • Oversee hiring, performance management, goal setting, compensation, terminations, and budget management
    • Maintain a highly engaged workforce focusing on development, performance and culture on the team

Your Skills Include:

  • At least 15 years of Operations experience with at least 5 years in Health Benefits Eligibility & Data
  • At least 10 years of steadily advancing leadership roles and a proven track record of success
  • Strong technical understanding of eligibility processing from start to finish
  • Experience in operational excellence, Lean, process reengineering and/or large-scale transformation
  • Experience taking a design and systems thinking approach
  • Proven track-record of leading major transitions to a new technologies, processes, and workflows, including any commercial implications
  • Eager to dive deep into details and personally drive results in complex and challenging environments in a start-up style environment
  • Ability to translate complex technical and operational concepts into measurable results, and vice versa.
  • Familiarity with EDI platforms and data flows
  • Benefits administration and/or Payer experience
  • Strong communications and leadership skills, while acting as a role model and coaching team members in Collective Health’s core values.
  • Ability to establish oneself as a peer and trusted partner, building strong cross-functional relationships, working across and break down organizational silos
  • Sets aggressive goals and is accountable for continuously driving improved performance, leading change and ensuring high standards
  • Courageously learns and tests new ideas, building a culture without fear of failure
  • Impeccable judgment and ability to make sound decisions in a fast-paced, dynamic setting.

Pay Transparency Statement

This is a hybrid position based out of either our Lehi, UT or Plano, TX office, with the expectation of being in office at least two-three weekdays per week. #LI-hybrid

The actual pay rate offered within the range will depend on factors including geographic location, qualifications, experience, and internal equity. In addition to the salary, you will be eligible for stock options and benefits like health insurance, 401k, and paid time off. Learn more about our benefits at https://jobs.collectivehealth.com/#benefits.

Lehi, UT Pay Range
$203,000$253,500 USD
Plano, TX Pay Range
$223,400$280,000 USD

About Collective Health

Collective Health is the leading health benefits platform that brings together medical, dental, vision, pharmacy, and program partners into an integrated solution that better enables employees and their families to understand, navigate, and pay for healthcare. By reducing the administrative lift of delivering health benefits, providing an intuitive member experience, and helping control costs and improve outcomes, the company guides employees toward healthier lives and companies toward healthier bottom lines.

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Collective Health is committed to providing support to candidates who require reasonable accommodation during the interview process. If you need assistance, please contact recruiting-accommodations@collectivehealth.com.

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