Business Transformation Advisor

Virtual Benefits Administrator

11h•Remote

About The Position

THE BUSINESS TRANSFORMATION ADVISOR IS A SENIOR, CLIENT-FACING ADVISOR WHO LEVERAGES DEEP TPA INDUSTRY EXPERTISE AND ADVANCED VBA PLATFORM KNOWLEDGE TO GUIDE CLIENT CONFIGURATION STRATEGY AND SOLUTION DESIGN. THIS ROLE ENSURES EACH CLIENT’S IMPLEMENTATION IS GROUNDED IN BEST PRACTICES, ALIGNED TO OPERATIONAL REALITIES, AND BUILT FOR LONG-TERM SCALABILITY AND ROI. BUSINESS TRANSFORMATION ADVISORS ADVISE CLIENTS ON PLATFORM CONFIGURATION, WORKFLOW DESIGN, AND KEY IMPLEMENTATION DECISIONS. THEY HELP CLIENTS NAVIGATE TRADEOFFS, APPLY INDUSTRY BEST PRACTICES, AND ADOPT APPROACHES THAT PROTECT PLATFORM INTEGRITY AND SUPPORT SUSTAINABLE OPERATIONS WELL BEYOND GO-LIVE. WORKING IN CLOSE PARTNERSHIP WITH PROJECT MANAGEMENT, CONFIGURATION SERVICES, TRAINING, DATA INTEGRATION, AND PRODUCT TEAMS, THE BUSINESS TRANSFORMATION ADVISOR TRANSLATES COMPLEX BUSINESS NEEDS INTO CLEAR, SCALABLE DESIGN RECOMMENDATIONS. CLIENT IMPACT AT VBA, CLIENT EXPERIENCE IS NOT OWNED BY A SINGLE TEAM—IT IS A SHARED RESPONSIBILITY ACROSS THE ORGANIZATION. THE BUSINESS TRANSFORMATION ADVISOR IS CENTRAL TO THAT COMMITMENT. IN THIS ROLE, YOU WILL: ACT AS A TRUSTED ADVISOR, HELPING CLIENTS MAKE INFORMED IMPLEMENTATION DECISIONS THAT SUPPORT SUSTAINABLE OPERATIONS. DESIGN SOLUTIONS THAT PRIORITIZE CLIENT OUTCOMES, USABILITY, AND OPERATIONAL EFFICIENCY, NOT JUST TECHNICAL COMPLETION. BRING A CLIENT ADVOCACY MINDSET TO EVERY ENGAGEMENT—ENSURING CLIENT NEEDS ARE CLEARLY UNDERSTOOD AND REPRESENTED ACROSS INTERNAL TEAMS. HOLD A HIGH BAR FOR IMPLEMENTATION QUALITY SO CLIENTS FEEL CONFIDENT, SUPPORTED, AND SUCCESSFUL FROM DAY ONE. SUCCESS IS MEASURED BY HOW WELL CLIENTS ARE POSITIONED AFTER IMPLEMENTATION WITH SCALABLE SOLUTIONS, CONFIDENT TEAMS, AND A TRUSTED LONG-TERM PARTNERSHIP WITH VBA. ABOUT VBA CONNECTED BY MISSION. DRIVEN BY INNOVATION. AT VBA, OUR MISSION IS SIMPLE BUT POWERFUL: WE MAKE THE HEALTHCARE EXPERIENCE BETTER FOR EVERYONE. WE HELP CLIENTS SIMPLIFY COMPLEX OPERATIONS THROUGH FULLY INTEGRATED SOLUTIONS SPANNING CLAIMS AND BENEFITS ADMINISTRATION, REVENUE CYCLE MANAGEMENT, PROVIDER AND NETWORK MANAGEMENT, CARE COORDINATION, AND AUTOMATION TOOLS. OUR TECHNOLOGY—RANGING FROM VBAPI’S THOUSANDS OF INTEGRATION ENDPOINTS TO PREDICTIVE ANALYTICS, BRANDED PORTALS, MOBILE ACCESS, AND AI-POWERED AUTOMATION—DRIVES EFFICIENCY, ACCURACY, AND BETTER OUTCOMES FOR MILLIONS OF PEOPLE WHO RELY ON THEIR HEALTH BENEFITS EVERY DAY. WHAT SETS US APART IS NOT JUST OUR PLATFORM, BUT OUR PEOPLE-CENTERED CULTURE: WE BLEND INNOVATION WITH FLEXIBILITY, EMPOWERING EMPLOYEES TO DO MEANINGFUL WORK, STAY CONNECTED ACROSS 25+ STATES, AND THRIVE IN AN ENVIRONMENT WHERE PURPOSE, COLLABORATION, AND GROWTH FUEL EVERYTHING WE DO.

Requirements

7+ YEARS OF EXPERIENCE WITHIN A SELF-INSURED TPA OR HEALTH PLAN ENVIRONMENT, WITH DIRECT, HANDS-ON EXPOSURE TO CORE OPERATIONAL SYSTEMS.
STRONG WORKING KNOWLEDGE OF CRITICAL TPA BUSINESS FUNCTIONS:
CLAIMS PROCESSING AND ADJUDICATION
BENEFIT AND PLAN DESIGN
ELIGIBILITY AND ENROLLMENT
STOP LOSS ADMINISTRATION
ACCOUNTING AND BILLING
PROVEN ABILITY TO GUIDE CLIENTS THROUGH COMPLEX OPERATIONAL, SYSTEM, AND MIGRATION DECISIONS WITH CREDIBILITY AND TRUST.
ADVISOR ON BEST PRACTICE MIGRATION STRATEGIES THAT ACCOUNT FOR STOP-LOSS CONTRACT COMPLEXITIES.
EXPERIENCE TRANSLATING BUSINESS AND OPERATIONAL NEEDS INTO SCALABLE SYSTEM DESIGNS AND WORKFLOWS.
STRONG EXECUTIVE-LEVEL COMMUNICATION AND RELATIONSHIP-BUILDING SKILLS, WITH THE ABILITY TO INFLUENCE DECISIONS THROUGH EXPERTISE.
WORKING KNOWLEDGE OF CORE PLATFORMS AND PROCESSES, INCLUDING CLAIMS, ELIGIBILITY, PROVIDER, AND INTEGRATION/EDI PLATFORMS

Responsibilities

Support RFP responses and tailor product demonstrations to prospect use cases and business functions.
Lead solution design discussions, proposals, and configuration concepts throughout the sales cycle.
Assess prospect fit with VBA’s ideal customer profile and expected ROI.
Serve as the primary strategic advisor on configuration and solution design during implementations.
Build trusted client relationships through clear guidance, accountability, and proactive communication.
Partner with Project Management to align on scope, timelines, risks, dependencies, and tradeoffs.
Provide direction through ambiguity, drive timely decisions, and resolve complex or escalated design challenges.
Ensure design choices support measurable ROI and a positive client experience.
Lead discovery to understand client operations, goals, and success criteria.
Translate requirements into scalable workflows, configurations, rules and data integrations.
Identify gaps between current processes and platform capabilities; recommend sustainable best-practice solutions.
Apply systems thinking to ensure solutions support long-term scalability and operational impact.
Configure portions of the platform as needed to demonstrate best practices and validate workflows.
Own solution quality, guiding clients toward maintainable, low-risk configurations.
Collaborate cross-functionally (Configuration, Training, Data Integration, Product, Engineering) to deliver well-scoped, effective solutions.
Contribute to implementation playbooks, templates, and best-practice documentation to improve consistency and client outcomes.
Share industry insights, workflow learnings, and regulatory updates with internal teams.
Mentor team members and share best practices to elevate delivery quality and consistency.
Stay current on industry trends, compliance requirements, and platform capabilities.