VP- Strategy & Operations, Risk Adjustment

Role Description

Who We Are:

UST HealthProof is a trusted partner for health plans, offering an integrated ecosystem for health plan operations. Our BPaaS solutions manage complex admin tasks, allowing our customers to prioritize members’ well-being. With our commitment to simplicity, honesty, and leadership, we navigate challenges with our customers to achieve affordable health care for all.

We have a strong global presence and a dedicated workforce of over 4000 people spread across the world.

Our brand is built on the strong foundation of simplicity, integrity, people-centricity, and leadership. We stay inspired in our goal to unburden healthcare and ensure it reaches all, equitably and effectively.

You Are

A VP of Strategy & Operations, Risk Adjustment who is responsible for leading the overall product development and implementation strategy of company’s risk adjustment platforms and services ensuring company and customer success through proven opportunities and outcomes.

The Opportunity

• Works to refine the company’s strategic approach with risk adjustment platforms & services.
• Supports the budgeting process and setting priorities for platform/service investments.
• Works collaboratively with onshore/offshore teams to deliver consistent product enhancements.
• Conducts and directs company market research around use of machine learning, automation, and NLP.
• Works with sales as an enterprise sponsor & SME to accelerate opportunities.
• Drives the company brand through networking with existing plan sponsor relationships.
• Builds company image by collaborating with customers, leadership, and employees.
• Stays abreast of regulatory requirements and company compliance policies, ensuring timely staff education.
• Provides vision, leadership, planning, project coordination, and management for developing a cost-effective department while concurrently facilitating efficient operations to meet current and future business needs within the organization.
  
  

What You Need

• Bachelor’s Degree in a related field
• At least 10 years of experience in a Health Care environment with demonstrated technical and strategic experience
• At least 5 years in a senior level management role in Healthcare
• Medicare Advantage revenue experience
• Significant experience with exposure to the Managed Care environment.
• Expertise in executing complex projects with the alignment of the clients.
• A thorough commitment to product development, and contract negotiations.
• Proven leadership in risk adjustment services, client engagement, operational processes and compliance.
• Significant experience managing others in a healthcare setting.
  
  

Compensation can differ depending on factors including but not limited to the specific location, role, skill set, education, and level of experience. As required by applicable law, UST HealthProof provides a reasonable range of compensation for roles that may be hired in various U.S. markets as set forth below.



Role Location: Remote

Compensation Range: 194,000-260,000

Benefits

Full-time, regular employees accrue up to 16 days of paid vacation per year, receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year), 10 paid holidays, and are eligible for paid bereavement leave. They are eligible to participate in the Company’s 401(k) Retirement Plan with employer matching. They and their dependents residing in the US are eligible for medical, dental, and vision insurance, as well as the following Company-paid benefits: basic life insurance, accidental death and disability insurance, and short- and long-term disability benefits. Regular employees may purchase additional voluntary short-term disability benefits, and participate in a Health Savings Account (HSA) as well as a Flexible Spending Account (FSA) for healthcare, dependent child care, and/or commuting expenses. Certain regular employees may have the potential for quarterly incentive-based bonuses and or commissions depending on role. Benefits offerings vary in Puerto Rico.

Part-time employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year) and are eligible to participate in the Company’s 401(k) Retirement Plan with employer matching.

Full-time temporary employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year) and are eligible to participate in the Company’s 401(k) program with employer matching. They and their dependents residing in the US are eligible for medical, dental, and vision insurance.

Part-time temporary employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year).

All US employees who work in a state or locality with more generous paid sick leave benefits than specified here will receive the benefit of those sick leave laws.

What We Believe

At UST HealthProof, we envision a bold future for American healthcare. Our values are the bedrock beliefs our organization holds dear. They not only define what our brand stands for but also serve as a compass guiding every action and decision.

Guiding Principles

These principles illuminate the path of ‘how’ we operate. They detail actions and behaviors we much embody to honor our values and achieve our goals.

• Simplicity
  
  

Simplifying complexity underlines everything we do—this approach is what makes us unique. We come with an open mind and straightforward approach, cutting our way to the core with measurable and actionable insights.

• Integrity
  
  

Integrity is our currency to build relationships. We believe in being open and honest. It is only natural when we have nothing to hide. It demonstrates that we are here to do the right thing, no matter who is watching.

• People-Centricity
  
  

Everything that we do reflects our deep bonds with peers and customers. These aren't mere transactions, but transformational ties. They shape our culture and decisions, affirming that our true value lies in the lives we touch and impact.

• Leadership
  
  

Taking ownership is about taking initiative, being in-charge and driving things to completion. It’s a brave choice to ‘own’ all aspects of our work, ensuring we take full responsibility for everything we handle.

Mission

A future possible only when health plans are free from administrative burdens so they can truly focus on what matters more – their members’ well-being.

Equal Employment Opportunity Statement

UST HealthProof is an Equal Opportunity Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other applicable characteristics protected by law. We will consider qualified applicants with arrest or conviction records in accordance with state and local laws and “fair chance” ordinances.

UST HealthProof reserves the right to periodically redefine your roles and responsibilities based on the requirements of the organization and/or your performance.

#Healthproof

Skills

Healthcare,Business Operations,Business Strategy