Health Plan Operations Lead
Vitable Health
full-time
Posted on:
Location Type: Remote
Location: United States
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Job Level
About the role
- Lead end-to-end health plan operations for self-funded and level-funded plans
- Serve as the primary operational contact for TPAs, PBMs, stop-loss providers, and vendors
- Oversee plan setup, implementation, renewals, and administration
- Ensure accurate eligibility, claims operations, billing, and reconciliation
- Monitor vendor performance and resolve issues proactively
- Collaborate with internal teams across product, finance, and client success
- Ensure regulatory compliance
- Identify operational efficiencies and improvements
- Support reporting, audits, and data reviews
Requirements
- 5+ years experience in health plan operations
- Experience working at a TPA or closely with TPAs, PBMs, and stop-loss carriers
- Strong understanding of self-funded and level-funded plans
- Experience managing multiple vendor relationships
- Knowledge of claims processing and benefits administration
- Strong organizational and communication skills
Benefits
- 100% Silver Plan + Full Medical Coverage
- Dental and Vision Coverage
- 401(k) and Life Insurance
- Access to Vitable’s Primary Care membership
- Unlimited PTO
- Remote-first culture with a supportive team
- MacBook and any other gear you need
- Home office setup stipend
- Competitive equity package
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
health plan operationsclaims processingbenefits administrationvendor managementregulatory compliancedata reviewsauditsoperational efficienciesplan setupimplementation
Soft Skills
organizational skillscommunication skills