What You Bring to Cambia** **Qualifications:** - 12-15+ years of progressive leadership experience in healthcare operations, strategy, consulting, or transformation roles - Demonstrated success leading large-scale operational transformation and performance improvement initiatives - Deep understanding of healthcare payer operations, including Utilization Management, Care Management, Pharmacy, Payment Integrity, and Appeals - Experience dri ving cost and affordability programs and managing financial outcomes - Strong executive communication and stakeholder management skills **Preferred:** - Experience leading AI, automation, or digital transformation initiatives - Background in healthcare consulting or enterprise transformation roles - Advanced degree (MBA, MPH, MHA, or similar) **Skills and Attributes:** - Strategic visionary with the ability to define and operationalize multi-year transformation roadmaps - Skilled at building alignment across clinical, operational, digital, and financial priorities - Proficient in continuous improvement methodologies such as Lean Agile, Six Sigma, and AI-enabled workflows - Strong analytical and data-driven decision-making capabilities - Effective change leader who can engage and align diverse stakeholders at all levels - Ability to translate complex strategies into clear, compelling executive narratives **What You Will Do at Cambia** - **Lead strategic transformation** by developing, organizing, and prioritizing a 3-year roadmap aligned to enterprise and HSO objectives - establishing governance, milestones, and value metrics to ensure execution and accountability - **Drive business process optimization** across HSO functions (UM, Care Management, Appeals, Pharmacy, Payment Integrity), delivering measurable improvements in operational efficiency, clinical quality, and member/provider experience - **Shape technology strategy** by defining business requirements for HSO technology initiatives and partnering with Digital, Technology, and Data teams to accelerate adoption of AI, automation, and digital capabilities - **Lead Cost Stewardship and affordability programs**, identifying medical cost drivers, developing targeted initiatives with clinical and finance partners, and ensuring alignment to enterprise affordability targets - **Deliver executive communications and change leadership**, including briefings, dashboards, and structured insights that support senior decision-making and drive alignment across the organization - **Build and develop high-performing teams** with a focus on accountability, innovation, continuous improvement, and data-driven outcomes You bring unique value to ur community of 200 leaders running our company. As a member of the Health Services Organization (HSO) leadership team, our VP of Business Optimization leads enterprise-level transformation - defining strategic roadmaps, optimizing clinical and operational performance, and driving affordability outcomes - all in service of creating an economically sustainable health care system.