Job Details

Vice President, Management Services Organization (MSO)

At Blue Zones Health we are redefining what it means to live a vibrant and healthy lifestyle. Inspired by long-living cultures around the world, we strive to empower people to make simple and sustainable lifestyle changes that lead to longer, better and more fulfilling lives. If you are ready to help transform well-being and be a pivotal part of our team, we want to meet with you!

Position Summary

The Vice President, MSO, is responsible for leading and transforming the operations of centralized operations supporting Blue Zones Health. This role focuses on enhancing performance, standardizing processes, and strengthening compliance across all delegated health plan functions.

The VP will drive continuous improvement in utilization management, claims, provider network management, quality, and data integration—ensuring operational excellence, scalability, and readiness for future growth.

Key Responsibilities

Operational Excellence & Transformation

• Lead the modernization and continuous improvement of MSO operations across UM, claims, provider data, credentialing, and member services.
• Assess current-state workflows and implement best-in-class process redesign to drive efficiency and consistency.
• Establish performance dashboards, service-level agreements (SLAs), and key performance indicators (KPIs) to monitor operational performance.
• Implement principles to reduce administrative waste and improve turnaround times.
• Strengthen coordination between MSO functional teams to enhance provider and patient experience.

Governance & Compliance

• Ensure full compliance with all regulatory requirements under the California Knox-Keene Act and Department of Managed Health Care (DMHC) standards.
• Maintain operational readiness for delegation oversight audits, including UM, claims, and credentialing functions.
• Partner with departments to update policies and procedures that reflect evolving CMS, DHCS, and health plan requirements.
• Serve as the executive sponsor for, and/or oversee, quality improvement, utilization management, and other relevant committees.

Performance & Financial Management

• Develop financial models to optimize administrative cost allocation and improve PMPM efficiency.
• Collaborate with Finance and Contracting to align operational budgets with performance outcomes.
• Establish performance-based incentives tied to IPA and health plan quality, utilization, and satisfaction metrics.
• Oversee vendor relationships and technology platforms to ensure cost-effective, high-quality service delivery.
• Lead efforts to strengthen interoperability between claims, UM, and provider systems.
• Partner with IT and analytics teams to develop actionable operational and population health reporting.
• Drive automation and data integrity improvements that enhance decision-making and regulatory reporting.
• Oversee the transition to digital workflows that support transparency and scalability across all IPAs.

Leadership & Culture

• Build and mentor a high-performing, mission-driven operations team.
• Foster a culture of accountability, transparency, and cross-functional collaboration.
• Partner closely with medical leadership to align operational performance with clinical outcomes.
• Act as a strategic thought partner to the CEO, CFO, and Board on delegated operations, risk readiness, and growth enablement.

Qualifications

Education & Experience

• Bachelor's degree in healthcare administration, business, or related field required; Master's degree preferred.
• 10+ years of progressive leadership experience in MSO, IPA, or delegated health plan operations.
• Deep knowledge of California's managed care regulatory environment, including RKK and Knox-Keene.
• Proven experience improving operational performance within delegated functions (UM, claims, QI, provider data).
• Demonstrated success leading process improvement, technology modernization, or shared services optimization.
• Strategic operator skilled in turning complex delegated operations into efficient, high-performing systems.
• Deep understanding of delegated risk operations, payor relations, and provider network management.
• Strong ability to lead teams through change while maintaining service continuity and morale.
• Expertise in operational performance management, analytics, and governance frameworks.
• Excellent communication and stakeholder management skills, particularly with clinicians and payors.

The compensation range for this position is $150,000 - $180,000.

This is a hybrid role requiring travel when needed.

For more information about Blue Zones Health, check us out at www.bluezoneshealth.com.

Blue Zones Health does not discriminate on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity or expression, age, disability, veteran status, or any other protected status under applicable law.