Chief Administrative Officer

Position Overview

Metro Plus
Health
is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.

Reporting to the President & Chief Executive Officer, the Chief Administrative Officer (CAO) serves as a senior executive responsible for the strategic leadership, integration, and operational performance of critical administrative and health plan functions. The CAO provides enterprise oversight of Claims, Provider Network Operations, Facilities Operations, Provider Contracting, Provider Credentialing, Core IT Systems Operations, Provider Data Management, Vendor Management, Payment Integrity, and Enrollment & Membership.

The role establishes a unified operating model across these functions to strengthen service delivery, regulatory compliance, financial stewardship, data integrity, technology reliability, and the experience of members, providers, employees, and business partners. As a member of the executive leadership team, the CAO translates organizational strategy into measurable operating plans, builds accountable leadership teams, manages enterprise risk, and advances continuous improvement across Metro Plus Health .

Scope of Role & Responsibilities

• Provide executive leadership and strategic direction for Claims, Provider Network Operations, Facilities Operations, Provider Contracting, Provider Credentialing, Core IT Systems Operations, Provider Data Management, Vendor Management, Payment Integrity, and Enrollment & Membership.
• Translate Metro Plus Health 's strategic priorities into integrated divisional objectives, operating plans, performance measures, budgets, and accountability structures.
• Build, coach, and retain a high-performing leadership team; clarify decision rights, strengthen succession planning, and promote collaboration across operational, clinical, financial, technology, legal, compliance, and regulatory functions.
• Establish an enterprise operating rhythm that includes performance reviews, risk escalation, issue resolution, portfolio prioritization, and transparent reporting to the President & Chief Executive Officer and other governance bodies, as requested.
• Ensure assigned functions operate in accordance with applicable federal, New York State, New York City, contractual, accreditation, privacy, security, and corporate requirements, in partnership with Legal, Compliance, Human Resources, Information Security, Finance, and Internal Audit.
• Oversee the end-to-end claims administration strategy, including accurate and timely adjudication, adjustments, quality assurance, payment integrity coordination, provider inquiry resolution, appeals support, testing, training, delegated activities, and remediation of systemic issues.
• Direct modernization and continuous improvement of claims operations through automation, analytics, standardized controls, root-cause analysis, and cross-functional resolution of configuration, authorization, eligibility, contract, and provider data issues.
• Lead Provider Network Operations to support network maintenance and expansion, provider relations, education, engagement, issue resolution, communications, service performance, and collaboration with clinical and regulatory partners.
• Provide executive oversight of provider contracting strategy and operations, including provider recruitment, negotiation, contract administration, value-based and other strategic arrangements, implementation readiness, and coordination of contractual terms with claims and provider data systems.
• Oversee credentialing and re-credentialing operations, including delegated…