Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

Reporting to the Chief of Contracting and Market Management, the Vice President, Market Operations provides executive oversight of market operations and is accountable for enterprise-wide consistency, scalability, and performance across all geographies. This leader serves as a senior strategic partner to Market Presidents and enterprise leadership, ensuring market strategies translate into measurable financial, quality, compliance, and growth outcomes. The Vice President, Market Operations defines and evolves the market operating model, leads transformation initiatives, and drives sustainable improvement in medical cost management, Stars performance, provider value based performance, and member experience. The role also establishes enterprise-wide performance governance and ensures cross-functional integration to achieve long-term organizational objectives.

Responsibilities:

Enterprise Market Strategy and Performance Accountability:

Provide executive oversight and accountability for market level performance across all regions, including but not limited to medical loss ratio (MLR), utilization management, quality performance, Stars, risk adjustment, provider performance and engagement, member experience, contracting, medical cost management, compliance, membership growth and retention.

Translate enterprise strategy into scalable market operating plans with clear, measurable financial and quality outcomes.

Establish standardized performance management frameworks across markets, including KPI governance, business reviews, escalation protocols, and corrective action planning.

Drive accountability with Market Presidents and functional leaders to achieve annual operating plans and multi-year strategic objectives.

Collaborate with Market Presidents to strengthen provider performance and engagement under Shared Risk, Global Risk, Gain Share and other value based arrangements.

Leverage operational and clinical data, including but not limited to claims, appeals, authorizations, HEDIS and pharmacy to support CMS compliance, quality and Stars performance.

Operational Excellence and Transformation:

Define and continuously evolve the market operating model to ensure scalability, consistency, and operational excellence across all markets.

Lead cross-market transformation initiatives focused on cost containment, quality improvement and operational efficiency.

Identify structural barriers to performance and implement enterprise-level solutions that reduce variation and improve outcomes.

Ensure operational readiness for market expansion, new product launches and regulatory changes.

Executive Cross-Functional Leadership:

Serve as the executive liaison between the markets and enterprise functions, including Network Management, Provider Operations, Finance, Quality, Utilization Management, Risk Adjustment, Clinical Operations, Compliance and Sales.

Drive cross-functional alignment to ensure market priorities are reflected in enterprise initiatives and resource allocation decisions.

Leverage market intelligence and competitive insights to influence market strategies.

Partner with executive peers to align incentive structures, performance metrics, and governance processes to achieve financial and quality goals.

Financial Stewardship and Risk Oversight:

In partnership with the Market Presidents, manage market P& L performance, including MLR, medical expense management and margin improvement.

Lead annual market operating plan and budget development in partnership with Market Presidents and Finance to ensure alignment with enterprise targets.

In collaboration with the Market Presidents, oversee risk pool performance and value based arrangements, ensuring financial transparency, reporting integrity, and strategic alignment with providers.

Identify financial risks and proactively implement mitigation strategies to protect enterprise performance.

Growth, Expansion & Market Sustainability

Partner with Market Presidents, Sales and Contracting leadership to support market expansion, network strategy, and competitive positioning.

Ensure operational readiness for new market entry and product expansion initiatives.

Drive provider engagement strategies that strengthen provider partnerships and long-term market stability.

Leadership & Talent Development:

Foster a culture of accountability, performance transparency, collaboration, and continuous improvement across markets.

Serve as an executive role model, reinforcing Alignment Health's values and leadership standards.

Provide executive coaching and strategic guidance to Market Presidents and market leadership teams.

Supervisory Responsibilities:

Oversees assigned staff that support the needs of the markets. Responsibilities include recruiting, selecting, orienting, and training employees; assigning workload; planning, monitoring, and appraising job results; and coaching, counseling, and disciplining employees.

Required Skills and Experiences:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.Reasonable accommodation may be made to enable individuals with disabilities to perform essential functions.

Minimum Experience:

At least 10 years of experience in healthcare.

At least ten years of managerial experience

Education/Licensure:

BA/BS Degree in business or a relevant field is required; an MBA is preferred.

Additional Skills and Qualifications: Strong understanding of Medicare Advantage operations, including Stars, medical management, network strategy, and regulatory requirements. Proven track record driving operational and financial performance. Demonstrated ability to lead cross-functional initiatives and influence senior leaders Strong analytical strategic thinking and problem solving skills. Experience developing and executing network strategies and market performance initiatives. Experience supporting multi-state, multi-market health plan operations. Experience working with delegated and non-delegated provider models. Strong understanding of provider contracting and payment methodologies, including Hospitals (DRG, per diem), Physicians (RBRVS, FFS, Capitation), value based arrangements and provider incentives. Excellent knowledge of managed care finance Strong interpersonal, relationship management, and executive communication skills, with the ability to convey complex information clearly. Proven ability to foster collaboration, value diverse perspectives, and gain alignment and buy-in for organizational initiatives. Excellent Microsoft Office skills, including Word and Excel 30% travel by car or air Available for evenings / weekends and extended work hours as needed

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform essential functions.

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
Pay Range: $227, 952.00 - $341, 928.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https: //reportfraud.ftc.gov/#/ . If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health's talent acquisition team, please email careers@ahcusa.com .