Vice President of Operations

The Jonus Group•San Antonio, TX

4d•$130,000 - $160,000•Onsite

About The Position

Seeking a seasoned and strategic Vice President of Operations to lead and optimize operational performance within a Third-Party Administration (TPA) organization. This executive role is pivotal in overseeing health benefits administration, operational infrastructure, compliance, client service delivery, and cross-functional performance. The successful candidate will ensure scalable growth, regulatory compliance, and exceptional client outcomes.

Requirements

10+ years of executive leadership experience in Third-Party Administration (TPA) within health benefits.
Demonstrated experience overseeing health plan operations and claims administration.
Strong knowledge of self-funded health plans, trust structures, and plan funding models.
Proven ability to manage multi-department operations and drive measurable performance improvements.
Experience with regulatory compliance and risk management in employee benefits administration.
Exceptional leadership, communication, and organizational skills.

Nice To Haves

Medical claims adjudication experience.
Direct experience working for or closely with a medical carrier.
Underwriting experience, including risk analysis and plan pricing support.
Experience with benefits administration platforms and claims processing systems.
Bachelor’s degree required; advanced degree (MBA, MHA, or related field) preferred.
Strategic thinker with operational depth.
Data-driven decision maker.
Expertise in change management.
Strong financial and business acumen.
Collaborative cross-functional leadership.
High integrity and accountability mindset.

Responsibilities

Provide executive leadership and strategic oversight for all operational functions, including claims administration, eligibility, billing, customer service, and compliance.
Drive operational excellence through process optimization, performance metrics, automation, and system enhancements.
Oversee medical claims operations, ensuring accuracy, timeliness, compliance, and cost containment.
Partner with underwriting, finance, and sales teams to support pricing strategies, risk evaluation, and client profitability.
Maintain a strong working knowledge of carrier relationships, stop-loss arrangements, and network contracting.
Ensure compliance with ERISA, HIPAA, ACA, FLSA, and applicable state and federal regulations.
Lead and mentor department leaders, fostering a high-performance, accountable, and client-focused culture.
Develop KPIs and reporting dashboards to monitor operational effectiveness and financial performance.
Identify and implement scalable infrastructure to support organizational growth.
Serve as an executive liaison with key clients, brokers, carriers, and vendor partners.