Assistant VP, Reference Pricing; RBP

Position: Assistant VP, Reference Based Pricing (RBP)
At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders - internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity and empower each other to illuminate our collective potential.

Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and upward!

Job Summary:

The Assistant Vice President (AVP) of Reference‑Based Pricing leads a high‑revenue, mission‑critical business unit responsible for operational performance, service delivery, and strategic growth across the RBP portfolio. This role oversees complex cost centers and functions, drives revenue and margin performance, and partners closely with product, technology, legal, and regulatory teams to advance the company's RBP strategy. The AVP serves as a senior operational leader with deep healthcare expertise, strong financial acumen, and the ability to influence both internal and external stakeholders in a highly regulated environment.

Job Role s & Responsibilities:

* Lead daily operations for high‑revenue RBP business units, ensuring quality, efficiency, and delivery against client and regulatory expectations.

* Own revenue performance, including annual budget achievement, margin optimization, and multi‑year growth planning.

* Develop and execute growth strategies in partnership with product, technology, sales, legal, and regulatory teams.

* Drive operation excellence through established/improved KPIs for productivity, cost‑to‑serve, cycle time, customer experience, and quality.

* Translate business needs into technical and service requirements, influencing automation, platform enhancements, and digital transformation initiatives.

* Partner with product and technology leaders to shape the technical roadmap and drive scalable, technology‑enabled operations.

* Serve as an external‑facing leader for clients, regulators, and strategic partners; manage escalations, appeals, and complex service issues.

* Ensure operational compliance with regulatory and legal requirements, including HIPAA.

* Lead, develop, and scale teams of 50-100+ employees, fostering engagement, accountability, and high performance.

* Direct financial planning and budgeting for assigned cost centers, balancing cost control with service excellence.

* Sponsor Agile development initiatives and major client implementations.

* Communicate performance, risks, and strategic updates to executive leadership.

* Ensure compliance with HIPAA regulations and requirements.

* Demonstrate Company's Core Competencies and values.

Job Requirements

* Must have at least 10 years of operational management/leadership experience; including 7 years in healthcare (insurance companies, TPA, HMO, managed care, or similar) ecosystem.

* Proven track record managing high‑revenue business units and delivering strong financial performance.

* Demonstrated success building and scaling large operational teams (50-100+ employees).

* Extensive experience managing client escalations, appeals, and litigation‑related issues within healthcare operations.

* Deep understanding of regulatory and legal frameworks impacting large healthcare organizations.

* Experience partnering on technical roadmaps and driving technology‑enabled operational strategies.

* Strong negotiation, communication, analytical, and organizational skills.

* Ability to collaborate effectively with internal teams and external stakeholders, including clients, regulators, and legal entities.

* Knowledge of healthcare and managed care products, including RBP methodologies.

* Ability to travel as needed.

* Bachelor's degree required; advanced degree preferred.

COMPENSATION

The salary range for this position is $160K-175K.  Specific offers consider a candidate's education, experience and skills, as well as the candidate's work location and internal equity.  This position is also eligible for…