Join Santa Clara Family Health Plan as Vice President, Operations | Salary $331K

A senior executive opportunity has been announced by Santa Clara Family Health Plan for the position of Vice President, Operations. This role sits at the center of organizational performance, responsible for ensuring that core health plan operations run efficiently, comply with regulatory requirements, and deliver high-quality services to members.

This position is designed for an experienced healthcare leader capable of managing complex systems, guiding large teams, and aligning operational execution with strategic goals in a highly regulated environment.

Strategic Leadership at the Core of Operations

The Vice President, Operations plays a critical role in overseeing key functional areas including enrollment and eligibility, customer service, grievances and appeals, and vendor management. These areas form the backbone of health plan operations and directly influence member experience and organizational performance.

In addition to ensuring operational efficiency, the role requires a strong focus on strategic alignment. The Vice President must ensure that all departments work cohesively toward organizational goals while maintaining compliance with federal and state healthcare regulations.

This includes working closely with executive leadership to translate strategy into measurable outcomes, improve service delivery, and ensure continuous organizational improvement.

Driving Regulatory Compliance and Accountability

Healthcare operations are heavily regulated, and this role requires deep expertise in compliance frameworks. The Vice President is responsible for ensuring adherence to standards set by DHCS and CMS, along with managing requirements such as APLs, DPLs, and Medicare Managed Care regulations.

A key part of the role involves preparing for and responding to regulatory audits, identifying gaps in compliance, and implementing corrective actions. This ensures that the organization maintains high standards of accountability while minimizing operational risk.

The ability to interpret complex regulatory guidance and embed it into operational workflows is essential for success in this position.

Enhancing Member Experience Through Data and Systems

A central responsibility of the role is improving the member experience. This includes analyzing trends in customer service interactions, grievances, and appeals to identify systemic issues and opportunities for improvement.

The Vice President must use data-driven insights to guide decisions, ensuring that operational changes lead to measurable improvements in service quality and accessibility.

Technology also plays an important role, as the position involves overseeing system implementation, evaluating digital tools, and ensuring that performance dashboards support real-time decision-making.

By integrating technology with operational strategy, the Vice President helps ensure that services are both efficient and responsive to member needs.

Leadership and Talent Development

Beyond operational oversight, this role is deeply focused on leadership development and organizational culture. The Vice President supervises senior directors and contract managers, ensuring strong performance across all operational units.

Key responsibilities include:

• Setting goals and performance expectations
• Conducting regular performance evaluations
• Recruiting and retaining top talent
• Supporting professional development and succession planning

The role also requires fostering a culture of accountability, collaboration, and continuous learning. Strong leadership skills are essential to guide teams through complex challenges while maintaining a focus on quality and service excellence.

Vendor and Stakeholder Management

Vendor management is another critical aspect of the position. The Vice President is responsible for overseeing contracts, evaluating vendor performance, and ensuring that external partners meet organizational standards.

In addition, the role requires external engagement with providers, regulators, and community stakeholders. Representing the organization in these settings demands strong communication skills and the ability to build trust and maintain professional relationships.

This external-facing responsibility ensures that the organization remains aligned with industry expectations and regulatory requirements.

Qualifications and Experience

The role requires extensive experience in healthcare operations, particularly in managed care environments. Candidates should bring:

• At least 10 years of senior leadership experience
• Strong understanding of Medi-Cal and/or Medicare systems
• Expertise in enrollment, customer service, and grievance management
• Experience with regulatory compliance and audit processes
• Proven ability to manage large teams and complex operations
• Strong analytical and financial management skills

A Bachelor’s degree is required, while a Master’s degree in healthcare or business administration is preferred.

The ideal candidate will also demonstrate strong communication skills, strategic thinking, and the ability to manage competing priorities in a high-pressure environment.

Compensation and Work Environment

This is a full-time executive position with a competitive salary range of $254,696 to $407,514 annually, depending on experience and qualifications.

The role is primarily office-based in San Jose, California, with occasional external meetings and stakeholder engagements. It requires a strong capacity for multitasking, attention to detail, and the ability to operate effectively in a structured but dynamic environment.

Conclusion

The Vice President, Operations role at Santa Clara Family Health Plan represents a high-impact leadership opportunity within the healthcare sector. It combines strategic oversight, regulatory expertise, and operational leadership in a single role that directly influences member experience and organizational performance.

For experienced healthcare executives, this position offers the chance to shape large-scale operational systems, improve service delivery, and contribute to a mission-driven organization focused on accessible and equitable healthcare services.

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