Senior Vice President, Operations - Remote

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day.

Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015.

The Senior Vice President (SVP), Operations is a key member of the Senior Leadership team responsible for leading operational strategy and execution across the Health Plan. Reporting directly to the Chief Operating Officer, the SVP serves as a strategic and transformational leader, ensuring organizational priorities are translated into measurable operational outcomes that advance the organization’s mission, financial sustainability, member experience, provider partnerships, and market competitiveness.

The SVP will oversee critical functions including Health Plan Operations (Claims and Member Services), Value-Based Care Strategy and Provider Engagement, Risk Adjustment, Health Plan Strategic Initiatives, Product Strategy and Management, Network Strategy and Performance, and Provider Contracting. This leader will drive cross-functional alignment and execution across the organization while fostering strong partnerships with the Delivery System, Clinical Leadership, Finance, Technology, and other Shared Services functions.

• Operations Strategy & Execution
  • Partners with the COO and Leadership Team to develop and execute organizational strategic priorities.
  • Translates strategic objectives into operational plans, initiatives, and measurable outcomes.
  • Ensures enterprise-wide alignment, accountability, and execution of key strategic initiatives.
  • Leads cross-functional efforts to advance organizational growth, operational effectiveness, and market competitiveness.
  • Serves as a key advisor to the COO on operational performance, business opportunities, emerging risks, and strategic investments.
  • Establishes governance structures and performance management processes to monitor strategic execution.
• Health Plan Operations Leadership
  • Provides executive oversight for core health plan operational functions, including:
  • Claims Operations
    • Drives operational excellence, accuracy, efficiency, and regulatory compliance.
    • Improves claims processing performance, provider satisfaction, and administrative cost effectiveness.
    • Leads modernization and automation efforts to enhance operational scalability.
  • Member Services and Member Experience
    • Establishes service strategies that improve member satisfaction and retention.
    • Drives performance through service excellence, operational efficiency, workforce optimization, and digital capabilities.
    • Ensures a member-centric culture across all operational teams.
• Value-Based Care Strategy & Provider Engagement
  • Leads development and execution of enterprise value-based care strategies.
  • Partners with clinical and delivery system leaders to advance population health, quality performance, and total cost of care initiatives.
  • Collaborates with provider organizations to improve quality outcomes, affordability, and care management performance.
  • Oversees provider education and engagement programs supporting value-based contracts and performance improvement initiatives.
  • Drives operational integration between payer and provider functions to achieve strategic goals.
• Risk Adjustment & Revenue Optimization
  • Provides executive oversight of enterprise risk adjustment strategy and performance.
  • Ensures effective collaboration across clinical, operational, analytics, and provider teams.
  • Advances coding accuracy, documentation improvement, and risk capture initiatives.
  • Monitors financial performance and regulatory compliance related to risk adjustment programs.
  • Identifies opportunities to strengthen organizational revenue performance…