Vice President, Claims Ops & Configuration

Vice President, MSO Operations

Department: Ops - Claims Ops

Employment Type: Full Time

Location: 1600 Corporate Center Dr., Monterey Park, CA 91754

Reporting To: Sherry Mc Bride

Compensation: $180,000 - $275,000 / year

About the Role: We are seeking a visionary leader who combines deep technical mastery with exceptional leadership acumen. As VP, MSO Operations, you will serve as a strategic architect and operational leader, driving innovation and excellence across end-to-end claims operations and system configuration. This role demands a forward-thinking leader who can influence enterprise-wide initiatives, optimize performance, and deliver scalable solutions that support national growth across all lines of business—Medicare, Medicaid, Commercial, and Health Insurance Exchange—while navigating complex risk models and delegated arrangements.

Your ability to leverage advanced technology, implement continuous process improvements, and foster a culture of accountability will be critical to success. This is a highly visible role with significant impact on organizational performance and strategic direction.

Our Values:

• Patients First
• Empowering the Independent Provider
• Be Innovative
• Operate with Integrity & Deliver Excellence
• Team of One

• Strategic Leadership: Define and execute the vision for end-to-end claims operations and configuration, ensuring alignment with enterprise objectives and regulatory compliance.
• Operational Excellence: Oversee adjudication, internal audits, provider dispute resolution, revenue recovery, and system configuration for provider contracts and health plan benefit structures.
• Performance Management: Establish and monitor KPIs, driving accountability and measurable outcomes across internal teams and external vendors.
• Regulatory Stewardship: Maintain deep knowledge of healthcare regulations and proactively address audit findings to mitigate risk and ensure compliance across all operating states.
• Innovation & Transformation: Partner with executive leadership to identify and implement automation, advanced analytics, and process enhancements that improve efficiency and scalability.
• Talent Development: Inspire, mentor, and empower high-performing teams, fostering a culture of excellence, collaboration, and continuous improvement.
• Enterprise
  
  Collaboration:
  
  Provide operational expertise for acquisitions, strategic projects, and technology implementations that advance organizational goals.

• Bachelor’s degree in business administration, health administration or related field (Master’s preferred).
• 12+ years of MSO / IPA operations experience, including 7+ years leading complex, delegated claims organizations.
• Proven ability to lead large-scale operations with precision and agility in dynamic environments.
• Executive presence with strong influencing skills and ability to build trust with senior leaders and external partners.
• Expertise in leveraging technology and data to drive operational performance and strategic decision-making.

• This is a hybrid role, two days a week in Monterey Park, CA.
• The annual salary range is $,000.

Astrana Health is proud to be an Equal Employment Opportunity and Affinitive Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need.

If you require assistance in applying for open positions due to a disability, please email us at humanre to request an accommodation.