Vālenz® Health

Vice President

• Develop and execute a strategic territory plan to grow Valenz Health's presence within the TPA marketplace
• Build and strengthen relationships with executive leaders and key decision-makers at regional and national TPAs
• Drive a consultative sales process from prospecting through close by identifying client needs, presenting tailored solutions, negotiating agreements, and achieving or exceeding revenue goals
• Position the Valenz Health platform as a strategic solution that enables TPAs to better serve their clients through improved cost management, quality, and member outcomes
• Identify opportunities to expand existing TPA partnerships while developing new relationships with regional and national third-party administrators
• Develop a deep understanding of the Valenz Health platform and clearly articulate our value proposition, competitive differentiators, and business impact
• Represent Valenz Health at industry conferences, association meetings, and networking events to strengthen market presence and generate new partnership opportunities
• Collaborate closely with Product, Marketing, Client Success, Operations, and executive leadership to develop winning strategies and support successful partner implementations
• Maintain accurate pipeline activity, forecasting, and opportunity management within the CRM while providing regular updates on territory performance and market insights.

VP, TPA Markets

Sales

VP, Sales – TPA Markets

• Develop and execute a strategic territory plan to grow Valenz's presence within the health plan and payer market.
• Build and strengthen relationships with executive leaders and key decision-makers across health plans, payer organizations, and other risk-bearing entities.
• Drive a consultative sales process from prospecting through close by identifying client needs, presenting tailored solutions, negotiating agreements, and achieving or exceeding revenue goals.
• Position the Valenz Health platform as a strategic solution that helps payer organizations strengthen payment integrity, improve payment accuracy, reduce healthcare costs, optimize claims performance, and enhance operational efficiency.
• Identify opportunities to expand existing client relationships while cultivating new business across assigned accounts and territories.
• Develop a deep understanding of the Valenz platform and clearly articulate our value proposition, competitive differentiators, and measurable business impact.
• Represent Valenz at industry conferences, association meetings, and networking events to strengthen market presence and generate new business opportunities.
• Collaborate closely with Product, Marketing, Client Success, Operations, and executive leadership to develop winning sales strategies and support successful client implementations.
• Maintain accurate pipeline activity, forecasting, and opportunity management within the CRM while providing regular updates on territory performance and market insights.

VP, Sales – Health Plans, Direct Payers

• Develop and execute a strategic territory plan to grow our Employer Markets business by building relationships with employers, brokers, consultants, and other key distribution partners.
• Drive a consultative sales process from prospecting through close by identifying client needs, delivering tailored solutions, negotiating agreements, and achieving or exceeding revenue goals.
• Build and maintain a robust pipeline through targeted prospecting, networking, industry events, referrals, and strategic outreach.
• Develop a deep understanding of Valenz's employer-focused solutions and clearly articulate our value proposition, competitive differentiators, and business impact to prospective clients.
• Partner with brokers, consultants, and employer decision-makers to identify opportunities and recommend solutions that help optimize health plan performance, improve the member experience, and better manage healthcare costs.
• Represent Valenz Health at industry conferences, association meetings, and networking events to strengthen market presence and generate new business opportunities.
• Collaborate closely with Product, Marketing, Client Success, Operations, and executive leadership to develop winning sales strategies and ensure a seamless client experience.
• Maintain accurate pipeline activity, forecasting, and opportunity management within the CRM while providing regular updates on territory performance and market insights.
• Partner with implementation and internal stakeholders to ensure a smooth transition from sale through onboarding and successful client launch.

VP, Sales – Employer Markets

VP, Health Plans – Direct Payers

• Drive new business growth across Employer Markets segment
• Build strategic relationships with employers, brokers, consultants, and key distribution partners
• Develop territory strategies and cultivate new opportunities
• Position Valenz's employer solutions to help organizations build higher-performing self-funded health plans
• Drive a consultative sales process from prospecting through close
• Build and maintain a robust pipeline through targeted prospecting, networking, and strategic outreach
• Develop a deep understanding of Valenz's employer-focused solutions
• Represent Valenz Health at industry conferences and networking events
• Collaborate closely with Product, Marketing, Client Success, Operations, and executive leadership
• Maintain accurate pipeline activity and forecasting within the CRM
• Partner with implementation and internal stakeholders for smooth transition from sale to onboarding

VP, Employer Markets

Medical Director

• Provide physician leadership in the development, implementation, and ongoing evaluation of evidence-based clinical guidelines, medical policies, and utilization management protocols to support high-quality, clinically appropriate decision-making.
• Ensure clinical programs, utilization review activities, and medical management processes align with current standards of care, evidence-based medicine, accreditation requirements, and applicable federal and state regulations.
• Serve as the clinical authority for complex, high-risk, or escalated utilization review cases by providing medical expertise, benefit interpretation, and final medical necessity determinations as appropriate.
• Promote consistency, accuracy, and defensibility in medical decision-making by applying sound clinical judgment and established medical necessity criteria across all review activities.
• Collaborate with Clinical Operations, Compliance, Legal, and executive leadership to develop, review, and revise clinical and administrative policies, medical necessity guidelines, and benefit interpretation criteria.
• Monitor changes in clinical practice guidelines, healthcare regulations, payer requirements, and industry best practices, recommending updates to organizational policies and review processes as necessary.
• Provide physician oversight for quality and performance initiatives by reviewing medical management outcomes, analyzing quality metrics, and participating in quarterly Quality Committee meetings and reporting.
• Participate in internal audits, accreditation activities, regulatory reviews, and quality improvement initiatives to ensure compliance with organizational standards and continuous operational excellence.
• Partner with operational leadership to ensure clinical standards are effectively integrated into utilization review workflows, promoting efficient, evidence-based, and member-focused medical management.
• Provide clinical consultation and recommendations regarding post-service medical necessity determinations, appeals, and other medically complex cases requiring physician review.
• Serve as a trusted clinical resource and advisor to physicians, nurses, utilization review staff, and cross-functional business partners by providing education, guidance, and consultation on medical policy and clinical best practices.
• Participate in interdisciplinary committees, physician advisory groups, and organizational meetings to provide clinical insight and support strategic initiatives.
• Foster collaborative relationships with internal and external stakeholders to promote quality outcomes, regulatory compliance, and continuous improvement across medical management programs.
• Perform other duties as assigned.

Medical Director – Part Time

Contracts Specialist

• Independently draft, review, revise, and negotiate complex commercial agreements
• Analyze and negotiate non-standard contract provisions
• Serve as the primary day-to-day Legal Department contact for assigned contracting matters
• Collaborate with Sales, Operations, Finance, IT, and Compliance teams and executive leadership
• Provide practical recommendations regarding contractual terms, risk allocation, and negotiation strategies
• Contribute to Legal team’s development and continuous refinement of contract templates
• Support and maintain contract lifecycle processes and systems

Senior Healthcare Contracts Specialist

• Actively prospect for new business with brokers and employers to generate leads through various techniques, including but not limited to, cold calls, email campaigns, and social media outreach.
• Build a pipeline of high-quality prospects to ensure consistent sales growth.
• Schedule meetings with prospects to introduce and present the Valenz Platform to Simplify Healthcare.
• Understand the prospects' unique needs and tailor proposals accordingly.
• Clearly communicate the value proposition and how they can enhance the prospect's business.
• Thoroughly understand all Valenz products and services, including their features, benefits, and competitive differentiators.
• Stay up-to-date on industry trends and developments.
• Attend industry events and tradeshows to network with prospects and generate new business.
• Respond promptly and accurately to all prospect inquiries, including requests for information, proposals, and pricing.
• Coordinate efforts to ensure that Valenz services are delivered efficiently and effectively.

VP, Broker Sales

Executive Assistant

• Manage and optimize the CEO's calendar, balancing competing priorities and ensuring effective use of time.
• Coordinate travel, including itineraries, accommodations, transportation, and meeting logistics.
• Prepare, edit, and organize presentations, correspondence, reports, and other executive materials.
• Serve as a primary point of contact for the CEO, screening inquiries and directing requests appropriately.
• Manage confidential information with the highest level of discretion and professionalism.
• Coordinate executive leadership meetings, senior leadership meetings, board-related activities, and strategic planning sessions.
• Prepare agendas, compile materials, document action items, and follow up on key deliverables.
• Assist with executive communications and ensure timely follow-through on commitments and priorities.
• Conduct research, gather information, and prepare briefing materials to support executive decision-making.
• Serve as the primary onsite contact for office operations and facilities-related needs.
• Coordinate office logistics for executive and senior leadership meetings held in the Dallas office.
• Manage relationships with office vendors, service providers, and building management.
• Support office supplies, equipment, meeting space readiness, and general workplace operations.
• Help coordinate internal events, leadership offsites, and employee gatherings.
• Partner with internal stakeholders to ensure a positive and professional office environment.
• Track action items and help drive accountability for executive and leadership team initiatives.
• Assist with special projects that support organizational priorities and business objectives.
• Identify opportunities to improve administrative processes, communication flow, and operational efficiency.
• Support additional executives or cross-functional teams as needed.

Executive Assistant – CEO

Revenue Operations

• Lead enterprise revenue planning and long-range growth modeling across all business lines
• Evaluate growth opportunities, investment priorities, and strategic initiatives through rigorous financial analysis
• Partner with executive leadership to establish revenue targets and growth assumptions
• Build scenario models that assess potential outcomes, risks, and strategic tradeoffs
• Serve as the strategic finance partner to Sales, Revenue Operations, Product, and Executive Leadership
• Assess the financial impact of pricing strategies, product launches, market expansion, and cross-sell initiatives
• Prepare and present strategic analyses and recommendations for executive leadership, board meetings, and private equity stakeholders
• Challenge assumptions, identify risks and opportunities, and improve visibility into business performance
• Lead enterprise revenue performance analysis across product lines, bundled offerings, and cross-sell activity
• Develop actionable insights that improve business decision-making and resource allocation
• Establish scalable forecasting methodologies, performance metrics, and governance processes
• Partner with Data and Revenue Operations to improve data quality, pipeline visibility, and reporting infrastructure
• Build and develop a high-performing Revenue Strategy and FP&A function
• Establish priorities, operating rhythms, and accountability frameworks that support business objectives
• Champion a culture of data-driven decision making and continuous improvement

Director, Revenue Strategy – FP&A

General

• Oversee and prioritize incoming requests within the Client Delivery Salesforce Case Queue, including Third-Party Administrator (TPA) enrollments and terminations, ensuring timely and accurate resolution.
• Evaluate and route client requests to the appropriate internal teams (e.g., product, engagement, technology) and monitor progress through completion.
• Maintain a strong operational understanding of all data files exchanged with clients.
• Support data integrity efforts by performing file audits, compiling Machine-Readable File (MRF) data summaries for client-facing teams, and identifying data gaps or issues that may affect product performance.
• Troubleshoot user access issues within Valenz Central, ensuring clients and internal stakeholders have appropriate platform functionality.
• Partner with the Client Delivery team on implementation-related activities to support smooth onboarding and client satisfaction.
• Perform other duties and special projects as assigned to support the Client Delivery function and organizational goals.

Client Delivery Coordinator

Executive Assistant – Office Operations Manager

Compliance

• Serve as the primary compliance liaison for Payment Integrity and Payment Operations, providing strategic guidance on regulatory and operational compliance matters.
• Interpret, analyze, and operationalize applicable regulatory requirements, including the No Surprises Act (NSA), Fraud, Waste & Abuse (FWA) laws, CMS requirements, and state Department of Insurance (DOI) regulations impacting payment and billing practices.
• Provide compliance oversight and guidance related to payment workflows, reimbursement methodologies, claims administration processes, and product development initiatives.
• Partner cross-functionally with operational leaders to identify, assess, and mitigate financial and regulatory compliance risks associated with payment and claims functions.
• Monitor and evaluate emerging regulatory developments, enforcement trends, and industry guidance to determine operational impact and support implementation of required changes.
• Support the development, review, implementation, and maintenance of financial and payment-related policies, procedures, and standard operating procedures (SOPs).
• Participate in high-risk initiatives, system implementations, process enhancements, and product changes to ensure compliance considerations are appropriately addressed.
• Assist with incident response activities involving payment disputes, FWA-related escalations, regulatory inquiries, and other compliance-related matters.
• Support internal audits, external audits, client audits, and regulatory examinations by coordinating documentation, responding to inquiries, and ensuring audit readiness.
• Collaborate with Corporate Compliance and cross-functional stakeholders on issue intake, triage, investigation support, tracking, corrective action planning, and resolution activities.
• Develop and deliver training, education, and compliance guidance to internal stakeholders regarding applicable regulatory requirements, policies, and operational expectations.
• Maintain accurate and organized documentation supporting compliance oversight activities, monitoring efforts, investigations, and audit preparedness.

Senior Compliance Specialist – Payment Integrity

• Serve as the primary compliance liaison for Care Management and Utilization Management operations, providing strategic guidance and oversight to ensure adherence to applicable regulatory and accreditation requirements
• Interpret, assess, and operationalize regulatory standards, including CMS Medicare Advantage and Managed Care requirements, NCQA and URAC accreditation standards, Utilization Review and Utilization Management regulations, and 42 CFR Part 2 requirements, as applicable
• Oversee and support the organization’s multi-state Utilization Management licensing program by tracking licensing requirements across applicable jurisdictions, coordinating license applications and renewals, maintaining supporting documentation, and partnering with operational leaders to ensure ongoing compliance with licensing conditions and regulatory obligations
• Provide compliance guidance and subject matter expertise related to clinical workflows, operational processes, policy development, and system implementations impacting Care operations
• Support the full lifecycle management of Care-related policies, standard operating procedures, and associated documentation
• Monitor regulatory developments and emerging compliance requirements, evaluate operational impact, and communicate relevant updates and recommendations to key stakeholders
• Participate in high-risk initiatives, operational enhancements, and product or process changes to ensure compliance considerations are appropriately addressed
• Support organizational readiness for audits, regulatory reviews, and accreditation activities, including NCQA and URAC surveys
• Assist with incident response activities involving Care operations, including privacy-related inquiries, compliance investigations, and regulatory escalations
• Collaborate with Corporate Compliance and cross-functional teams on issue intake, triage, tracking, remediation, and resolution efforts
• Provide education, training, and ongoing guidance to internal stakeholders regarding applicable regulatory and compliance requirements
• Maintain accurate and organized documentation to support compliance activities, regulatory inquiries, audits, and accreditation requirements