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Vice President of Operations, CHS MSO / TPA

COPE Health Solutions

Downtown Los Angeles, CA

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JOB DETAILS
SALARY
$207,900–$260,000 Per Year
SKILLS
Acquisition Integration, Automation, Budget Management, Budgeting, Business Administration, Business Performance Management, Business Strategy, Call Center Evaluation, Centers for Medicare and Medicaid Services (CMS), Communication Skills, Continuous Improvement, Contract Management, Contract Requirements, Corrective Action, Cost Control, Cost Forecasting, Cross-Functional, Customer Relations, Customer Relationship Management (CRM) Systems, Federal Laws and Regulations, Finance, Financial Management, Financial Operations, Health Plan, Healthcare, Healthcare Administration, Healthcare Providers, Leadership, Maintain Compliance, Managed Care, Medicaid, Medicare, Metrics, National Committee for Quality Assurance (NCQA), Negotiation Skills, Operational Audit, Operational Measurement, Operational Strategy, Operational Support, Operations Management, Operations Planning, Organizational Development/Management, Performance Management, Performance Metrics, Problem Solving Skills, Process Improvement, Profit & Loss, Quality Management, Quality Metrics, Regulations, Regulatory Compliance, Regulatory Requirements, Reporting Dashboards, Risk, Risk Management, Service Delivery, Service Level Agreement (SLA), State Laws and Regulations, Strategic Planning, Succession Planning, Sustainability, System Integration (SI), Systems Administration/Management, Team Lead/Manager, Team Player, Utilization Management, Vendor/Supplier Selection
LOCATION
Downtown Los Angeles, CA
POSTED
30+ days ago
The Vice President of Operations is responsible for the overall operational performance of the Management Services Organization (MSO) / Third‑Party Administrator (TPA). Reporting directly to the Chief Executive Officer, the Vice President of Operations provides enterprise‑level leadership for day‑to‑day operations, vendor and delegate oversight, financial and operational performance, regulatory compliance, and execution of strategic initiatives.
 
The Vice President of Operations partners closely with executive leadership, health plans, providers, and external vendors to ensure efficient, compliant, and scalable operations that support high‑quality service delivery and sustainable growth across all lines of business and serves as the executive owner of MSO/TPA operational functions.
 

FLSA Status
Exempt
Salary Range
$207,900-260,000
Reports To
Principal and SVP
Direct Reports
No
Location
Hybrid in LA Office
Travel
Up to 10%
Work Type
Regular
Schedule
Full Time
 
Key Responsibilities
Operational Leadership
  • Direct and oversee all internal and subcontracted operational functions of the MSO/TPA, including utilization management, care management, credentialing, quality improvement, call center/member services, enrollment, claims administration, configuration, provider network and data operations, and operational analytics.
  • Establish and maintain standardized policies, procedures, controls, and workflows to drive efficiency, consistency, and regulatory compliance.
  • Lead operational performance management through defined KPIs, service levels, dashboards, and continuous improvement initiatives.
  • Serve as an executive decision‑maker for operational policies, workflows, and resourcing decisions within approved strategy and budget.
  • Identify operational investments, infrastructure changes, and remediation actions impacting enterprise performance.
 
Vendor and Delegation Oversight
  • Manage contractual, operational, and performance relationships with clients, delegated entities, and key vendors.
  • Ensure adherence to contractual requirements, service‑level agreements (SLAs), quality standards, and regulatory obligations.
  • Lead vendor selection, contracting support, performance remediation, and ongoing operational governance.
  • Serve as the executive authority for vendor and delegate issue escalation, resolution, and corrective action approval.
 
Financial and Budget Oversight
  • Partner with Finance to develop and manage operating budgets, forecasts, and cost‑containment initiatives.
  • Own operational P&L, including expense controls, productivity metrics, and margin optimization.
  • Identify operational efficiencies and scalability opportunities that drive financial sustainability.
  • Maintain accountability for operational cost structure design, staffing models, and productivity optimization.
  • Partner with the CEO and CFO to align operational performance with enterprise financial goals and growth strategy.
 
Quality, Compliance and Risk Management
  • Ensure compliance with federal, state, and payer regulations (e.g., CMS, Medicaid, delegated functions).
  • Oversee delegation oversight, audit readiness, regulatory findings, corrective action plans, and internal controls.
  • Promote a culture of quality, accuracy, and risk awareness across all operational teams.
 
Strategic Execution
  • Translate organizational strategy into executable operational plans and measurable outcomes.
  • Align disparate operational functions into a unified strategy that supports organizational growth and compliance.
  • Lead operational aspects of growth initiatives, including new lines of business, new markets, acquisitions, integrations, and system implementations.
  • Drive process improvement, automation, and technology modernization across core operational functions.
  • Ensure operational scalability and organizational readiness to support strategic growth and market expansion.
 
People and Organizational Leadership
  • Build, lead, and develop a high‑performing operational leadership team.
  • Establish clear accountability structures, performance expectations, and professional development pathways.
  • Foster a culture of collaboration, ownership, and continuous improvement.
  • Design the operational organizational structure to support future growth, succession planning, and long‑term enterprise maturity.
 
Executive and Stakeholder Engagement
  • Serve as a key advisor to the CEO and leadership team on operational performance, risks, and opportunities.
  • Prepare and present operational updates, metrics, and recommendations to executive leadership and governing bodies.
  • Collaborate with internal and external stakeholders, including payers, providers, regulators, vendors, and partners.
  • Represent operations in executive, Board, and committees as assigned by the CEO.
 
Qualifications
Education and Experience
  • Bachelor’s degree in Healthcare Administration, Business Administration, or a related field (Master’s degree or MBA strongly preferred).
  • Minimum of 15+ years of progressive leadership experience in MSO, TPA, managed care, health plan, or healthcare operations.
  • Experience overseeing large‑scale, complex healthcare operations and delegated functions with enterprise‑level accountability.
  • Experience supporting Medicaid Managed Care, Medicare Advantage, and/or Commercial health plans.
  • Prior accountability for MSO/TPA performance management and delegated operations.
 
Preferred Experience
  • Experience leading growth initiatives, system implementations, integrations, or operational turnarounds.
  • Familiarity with healthcare administration platforms (claims, enrollment, UM, CRM, reporting tools).
 
Core Competencies
  • Deep understanding of managed care operations, TPA administration, and healthcare regulatory requirements.
  • Strong financial acumen, including budgeting, forecasting, and operational cost management.
  • Proven ability to lead cross‑functional teams and execute change in complex environments.
  • Experience with operational analytics, performance metrics, and continuous improvement methodologies.
  • Excellent communication, negotiation, and stakeholder management skills.
 
Leadership
  • Strategic thinker with strong execution discipline
  • Results‑oriented and data‑driven
  • Collaborative, decisive, and accountable
  • High integrity and commitment to compliance and quality
  • Comfortable operating in fast‑paced, highly regulated environments
 
Benefits: 
As a firm passionate about health care, we’re deeply committed to the health and wellness of our own team members. We offer comprehensive, affordable insurance plans for our team and their families, and a host of other unique benefits, such as a yearly stipend for wellness-related activities and a paid parental leave program. You can learn more about our benefits offerings here: https://copehealthsolutions.com/careers/why-cope-health-solutions/. 
 
About COPE Health Solutions
COPE Health Solutions is a national tech-enabled services firm powering success for health plans and for providers in risk arrangements. Our comprehensive NCQA certified population health management platform and highly experienced team brings deep expertise, experience, proven tools, and processes to improve financial performance and quality outcomes for all types of payers and providers. CHS de-risks the roadmap to advanced value-based payment and improves quality and financial performance for providers, health plans and self-insured employers. For more information, visit CopeHealthSolutions.com. 
To Apply: 
To apply for this position or for more information about COPE Health Solutions, visit us at https://copehealthsolutions.com/careers/open-positions/.
 
 

About the Company

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COPE Health Solutions

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