VP of Business Optimization

Cambia Health Solutions • Portland, OR

2d • Remote

About The Position

Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Every day, Cambia's dedicated team is living our mission to make health care easier and lives better. As a member of the Health Services Organization (HSO) leadership team, our VP of Business Optimization leads enterprise-level transformation — defining strategic roadmaps, optimizing clinical and operational performance, and driving affordability outcomes — all in service of creating an economically sustainable health care system. As a people leader, you are willing to learn and grow, understanding that leadership is a craft that is continuously honed as you support your team and the lives that depend upon us. Do you have a passion for translating complex strategy into measurable, real-world results? Do you thrive at the intersection of clinical operations, technology, and business performance — leading cross-functional teams toward bold, lasting change? Then this role may be the perfect fit.

Requirements

• 12–15+ years of progressive leadership experience in healthcare operations, strategy, consulting, or transformation roles
• Demonstrated success leading large-scale operational transformation and performance improvement initiatives
• Deep understanding of healthcare payer operations, including Utilization Management, Care Management, Pharmacy, Payment Integrity, and Appeals
• Experience driving cost and affordability programs and managing financial outcomes
• Strong executive communication and stakeholder management skills

Nice To Haves

• Experience leading AI, automation, or digital transformation initiatives
• Background in healthcare consulting or enterprise transformation roles
• Advanced degree (MBA, MPH, MHA, or similar)

Responsibilities

• Lead strategic transformation by developing, organizing, and prioritizing a 3-year roadmap aligned to enterprise and HSO objectives — establishing governance, milestones, and value metrics to ensure execution and accountability
• Drive business process optimization across HSO functions (UM, Care Management, Appeals, Pharmacy, Payment Integrity), delivering measurable improvements in operational efficiency, clinical quality, and member/provider experience
• Shape technology strategy by defining business requirements for HSO technology initiatives and partnering with Digital, Technology, and Data teams to accelerate adoption of AI, automation, and digital capabilities
• Lead Cost Stewardship and affordability programs , identifying medical cost drivers, developing targeted initiatives with clinical and finance partners, and ensuring alignment to enterprise affordability targets
• Deliver executive communications and change leadership , including briefings, dashboards, and structured insights that support senior decision-making and drive alignment across the organization
• Build and develop high-performing teams with a focus on accountability, innovation, continuous improvement, and data-driven outcomes

Benefits

• Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
• Annual employer contribution to a health savings account.
• Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
• Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).
• Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).
• Award-winning wellness programs that reward you for participation.
• Employee Assistance Fund for those in need.
• Commute and parking benefits.

What This Job Offers

• Job Type: Full-time
• Career Level: Executive