Strategic Operations Manager - Range Health

Blue Cross of Idaho•Meridian, ID

14d•Hybrid

About The Position

Range Health is a growing healthcare organization bringing high-quality products to new markets. Supported by the strength, expertise, and shared services of Blue Cross of Idaho, Range Health combines entrepreneurial agility with established healthcare experience. At Range Health, you will have the opportunity to help shape a start-up emerging health plan from the ground up. Working at a start-up health plan is a fast-paced experience involving changing demands, constant learning and opportunities. This role offers a chance to drive a differentiated experience in the US health care system with meaningful exposure across operations, technology, vendor partnerships, compliance, financial performance, and market growth. You will not simply inherit an established playbook. You will help create the structure, relationships, and operating practices that enable consistent performance today and scalable growth in the future. If you enjoy bringing clarity to complexity, turning insights into action, being creative and solution oriented, and building something new with collaborative leaders, this may be the right opportunity for you. The Strategic Operations Manager serves as the operational integrator for Range Health, providing end-to-end oversight of a complex, operating model supporting Medicare Advantage and Medicare Supplement plans, with the intent to expand into new markets and products. This role is the primary point of coordination for operational and technology performance across, vendor partners, and internal business owners and senior leadership. The Strategic Operations Manager monitors service delivery, contract performance, operational metrics, technology dependencies, and emerging risks while ensuring issues are routed to the appropriate owners and driven through resolution. Working across core health plan functions enrollment, claims, member services, grievances and appeals, utilization management, care management, risk adjustment, quality, and other plan functions, this position creates the structure, visibility, and accountability needed to deliver consistent outcomes for our members. The role combines vendor relationship management, operational analysis, cross-functional leadership, and hands-on execution in a growing and evolving health plan environment. The ideal candidate is a collaborative, adaptable self-starter who is comfortable creating structure where it does not yet exist, working through ambiguity, and influencing outcomes across teams driving to decisions without relying on direct authority.

Requirements

At least five years of health plan, managed care, or related experience.
Experience coordinating complex work across multiple business functions, vendors, or operational business partners.
Experience using operational data, performance reporting, or business metrics to identify issues and drive action.
Demonstrated ability to manage competing priorities, resolve issues, and execute effectively in an evolving environment.
Experience influencing business partners, managing stakeholders and senior leadership.
Bachelor’s Degree or equivalent work experience (Two years’ relevant work experience is equivalent to one-year college)

Nice To Haves

Familiarity with Medicare Advantage, Medicare Supplement, CMS requirements, or regulated health plan operations.
Experience managing third-party administrators, outsourced business processes, BPaaS relationships, or other complex vendor partnerships.
Experience monitoring contracts, statements of work, service-level agreements, performance guarantees, or vendor scorecards.
Experience working across health plan functions such as claims, enrollment, member services, utilization management, care management, grievances and appeals, quality, risk adjustment, compliance, finance, or technology.
Experience conducting operational trend analysis, root-cause analysis, process improvement, or performance remediation.
Experience supporting an emerging business, new product, market expansion, or rapidly changing operating model.
Agility and flexibility to handle multiple responsibilities and comfort with a fast-paced and changing environment.
Strong operational judgment and ability to understand how decisions or performance issues in one function affect end-to-end business outcomes.
Ability to translate performance data into clear findings, recommendations, and actions.
Strong vendor relationship management, negotiation, escalation, and issue-resolution skills.
Ability to create practical structure, governance, and accountability in an ambiguous environment.
Strong collaboration and influencing skills across business, technology, compliance, finance, and leadership partners.
Clear and confident written, verbal, and executive-level communication skills.
Ability to move comfortably between strategic context and hands-on execution.
Ability to take initiative, along with curiosity, adaptability, and a willingness to roll up your sleeves.
Sound judgment when handling sensitive operational, contractual, financial, or regulatory information.
Commitment to continuous improvement, service quality, and measurable results.

Responsibilities

Provide end-to-end oversight of operational performance and workflows supporting initial Range Health Medicare Advantage plans, including enrollment, claims, member services, grievances and appeals, utilization management, care management, risk adjustment, quality, and STARs performance.
Serve as the central point of coordination across Range Health, Blue Cross of Idaho business leadership, contract owners, technology partners, and operational vendors and senior leadership
Connect activities across functional workstreams to identify dependencies, performance gaps, and issues that may affect members, providers, regulatory commitments, financial results, or business objectives.
Establish clear operating routines, escalation pathways, decision structures, and accountability mechanisms for the operating model.
Lead recurring operational performance meetings and steering committee discussions, including preparation of performance updates, risks, decisions, and follow-up actions.
Track issues through resolution, confirm that corrective actions address the underlying concern, and bring up unresolved or systemic risks to the appropriate leaders.
Lead day-to-day operational relationships with the third-party administrator and other key vendors.
Monitor vendor performance against statements of work, service-level agreements, performance guarantees, key performance indicators, quality expectations, and other contractual commitments.
Partner with internal business owners and contract owners to evaluate vendor results, address performance concerns, and support contract value realization.
Facilitate issue escalation and resolution between vendors, technology teams, operational leaders, subject matter experts, and executive stakeholders.
Support quality assurance activities and evaluate whether vendor remediation plans deliver timely and sustainable improvement.
Find opportunities to reduce fragmentation across vendors and improve accountability for end-to-end outcomes.
Monitor and analyze operational measures such as enrollment timeliness, retention, claims lag, service performance, quality measures, vendor performance, and other plan indicators.
Perform second-level analysis to identify trends, relationships, root causes, emerging risks, and opportunities requiring additional action.
Translate complex operational data into concise insights, recommendations, and decisions for plan leadership.
Develop and maintain reporting processes that provides insight into operational, technology, regulatory, service, and financial performance.
Partner with finance and business leadership to understand the operational drivers affecting revenue, cost, performance guarantees, and P&L objectives.
Coordinate with compliance, legal, audit, and business resources to support adherence to federal requirements, state insurance regulations, organizational policies, and contractual obligations.
Support compliance teams with regulatory filings, audit activities, submissions, and remediation efforts by coordinating operational information and owner accountability.
Identify and raise operational, vendor, technology, data, and compliance risks to the appropriate leaders to ensure operational concerns with potential regulatory impact are promptly elevated to compliance resources for review and direction.
Support documentation and governance practices that strengthen regulatory readiness and organizational oversight.
Identify and implement operational efficiency, process optimization, and service improvement opportunities.
Participate in the design, implementation, and evaluation of systems, processes, and operating methods intended to improve quality, enhance customer service, and reduce costs.
Develop repeatable processes and governance practices that can scale as Range Health expands into additional products, markets, or states.
Balance immediate operational needs with the development of a sustainable future-state operating model.
Perform other duties and responsibilities as assigned.