Compare your current skills to what this opportunity needs—we'll show you what you already have and what could strengthen your application.
Job Description
Position Overview The Vice President of Operations is a senior leadership role responsible for overseeing end-to-end operational delivery for a Third-Party Administrator (TPA) specializing in government-sponsored and public sector benefits programs. This individual will drive operational excellence, regulatory compliance, scalability, and client satisfaction across complex, multi-jurisdictional contracts (e.g., state, municipal, and federal programs). The VP will serve as a strategic partner to executive leadership and a key liaison to government clients, ensuring high-performance service delivery aligned with contractual obligations, compliance standards, and evolving regulatory requirements. Key Responsibilities Operational Leadership Lead all core TPA operations including eligibility, enrollment, billing, claims administration, customer service, and vendor management. Drive continuous improvement initiatives to enhance efficiency, accuracy, and service quality across operations. Develop and implement scalable operating models to support growth in government contracts and membership expansion. Government Contract Execution Oversee operational execution of public sector contracts, ensuring strict adherence to SLAs, performance guarantees, and contractual requirements. Partner with legal, compliance, and client teams to interpret and operationalize RFP requirements, amendments, and regulatory mandates. Act as a senior escalation point for government clients and stakeholders. Compliance & Regulatory Oversight Ensure full compliance with federal, state, and local regulations, including but not limited to:
ERISA, HIPAA, ACA CMS
guidelines (as applicable) State-specific public program requirements Maintain audit readiness and lead responses to external audits, program reviews, and performance evaluations. Client & Stakeholder Management Build trusted relationships with government agencies, plan sponsors, consultants, and key partners. Participate in client governance meetings, reporting on operational performance, KPIs, and improvement initiatives. Support business development efforts, including RFP responses, oral presentations, and transition planning. Team Leadership & Development Lead and mentor a high-performing operations organization, including directors and department heads. Establish a culture of accountability, collaboration, and customer-centric service. Align organizational structure and talent strategy with growth objectives and contract demands. Technology & Process Optimization Partner with IT and product teams to enhance TPA platforms, automation, and reporting capabilities. Champion data-driven decision-making using performance metrics and analytics. Lead system implementations, conversions, and integrations tied to new government contracts. Qualifications Required Experience 12+ years of experience in benefits administration, TPA operations, or managed care. 5+ years in senior leadership (VP or equivalent) overseeing large-scale operations. Demonstrated success managing government contracts (state, federal, or municipal), including Medicaid, public employee benefits, or similar programs. Deep understanding of health & welfare benefits administration . Technical & Functional Expertise Strong knowledge of: Claims and eligibility systems TPA operating models Regulatory frameworks (ERISA, HIPAA, ACA, CMS where applicable) Experience managing complex SLAs, KPIs, and performance guarantees tied to government contracts. Leadership & Soft Skills Executive presence with strong client-facing capabilities. Proven ability to lead large, distributed teams. Strategic thinker with a hands-on, execution-oriented approach. Exceptional problem-solving and process improvement mindset. Preferred Qualifications Experience with public sector consulting or working with labor unions, multi-employer plans, or government-sponsored programs. Background supporting RFPs and implementations for new government contracts. Lean Six Sigma or operational excellence certification. Master's degree (MBA, MHA, or related field).
Compensation Base Salary:
$200,000-$275,000 (flexible based on experience)
Bonus:
Performance-based annual incentive (20-40%) Long-term incentives/equity (if applicable) Comprehensive benefits package Why This Role Opportunity to lead operations for mission-critical public sector programs. High visibility with executive leadership and government stakeholders. Ability to drive meaningful impact in healthcare and benefits access at scale.
