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Health Plan Operations Jobs (NOW HIRING)

About the role The Health Plan Operations Partner helps Evio strengthen relationships with our investor/customer health plans, driving coordinated and effective relationships. You'll be a strategic ...

About the role The Health Plan Operations Partner helps Evio strengthen relationships with our investor/customer health plans, driving coordinated and effective relationships. You'll be a strategic ...

The Sr. Analyst, Health Plan Performance (HPP) Ops is responsible for extracting, analyzing, and ... Day-to-Day Operations * Source, clean, and organize data from multiple streams (payer portals, Rx ...

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Health Plan Operations information

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$9

$24

$49

How much do health plan operations jobs pay per hour?

As of Sep 11, 2026, the average hourly pay for health plan operations in the United States is $24.15, according to ZipRecruiter salary data. Most workers in this role earn between $15.38 and $27.64 per hour, depending on experience, location, and employer.

What is health plan operations?

Health Plan Operations refer to the processes and activities involved in managing the daily functions of a health insurance plan. This includes tasks such as member enrollment, claims processing, provider network management, customer service, regulatory compliance, and quality assurance. Effective health plan operations ensure smooth delivery of healthcare benefits to members, maintain accurate records, and support financial and regulatory goals for the organization. These operations are crucial for delivering high-quality service and maintaining the trust of both providers and members.

What are the key skills and qualifications needed to thrive in health plan operations?

To excel in Health Plan Operations, a strong background in healthcare administration, data analysis, and regulatory compliance is essential, often supported by a bachelor's degree in healthcare management or a related field. Familiarity with claims processing systems, health information management software, and knowledge of HIPAA regulations are typically required. Exceptional organizational skills, attention to detail, and effective communication set high performers apart in this role. These skills ensure efficient health plan administration, regulatory adherence, and optimal service delivery to members and providers.

What are some common challenges faced in a health plan operations role, and how can new hires prepare to address them?

Professionals in Health Plan Operations often encounter challenges such as navigating complex regulatory requirements, managing cross-functional communication, and ensuring process efficiency while maintaining compliance. New hires can prepare by familiarizing themselves with relevant healthcare regulations (like HIPAA and ACA), developing strong organizational and analytical skills, and being proactive in collaborating with teams such as claims, provider relations, and IT. Building a solid understanding of internal procedures and fostering relationships across departments can help streamline workflows and address operational issues more effectively.

What is the difference between Health Plan Operations vs Claims Processor?

AspectHealth Plan OperationsClaims Processor
Primary RoleOversees overall health plan functions, including member services, provider relations, and complianceReviews and processes individual insurance claims for payment
Required CredentialsTypically requires knowledge of healthcare regulations, insurance policies, and sometimes certifications in health administrationOften requires familiarity with claims processing systems and basic insurance knowledge
Work EnvironmentOffice-based, collaborative teams, health insurance companies or managed care organizationsOffice or call center, focused on claims review and data entry

Health Plan Operations professionals manage the broader functions of health insurance plans, ensuring compliance and member satisfaction, while Claims Processors focus specifically on evaluating and processing insurance claims. Both roles are essential in the healthcare insurance industry but differ in scope and responsibilities.

What do you do in health plan operations?

Health plan operations professionals manage the daily functions of health insurance plans, including claims processing, member enrollment, provider network management, and compliance with healthcare regulations. They often use specialized software and require strong organizational and communication skills to ensure efficient plan administration.
More about Health Plan Operations jobs

What states have the most Health Plan Operations jobs?

States with the most job openings for Health Plan Operations jobs include:

Health Plan Operations Partner

Remote

$120K - $140K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 24 days ago


Job description

About the role

The Health Plan Operations Partner helps Evio strengthen relationships with our investor/customer health plans, driving coordinated and effective relationships. You'll be a strategic and operational partner to the Chief Customer Officer, helping Evio engage customers in a consistent, thoughtful way that continues to establish Evio as a partner that delivers essential value.

A major focus of this role is serving as the operational steward of Evio's Customer Advisory Committee (CAC), our senior forum for investor/customer collaboration. You'll also coordinate customer engagement across different parts of Evio, surface and synthesize insights on product adoption and value, and support annual customer business and financial planning/budgeting.

This is a high-ownership role for someone comfortable moving between strategy and hands-on execution-from shaping an executive narrative and building strong communications materials to coordinating complex work across teammates and customers. It is also a key steppingstone role to other parts of Evio's business.

What you'll do

  • Partner with the Chief Customer Officer on customer strategy and execution. Help prioritize key initiatives, coordinate work across Evio, and ensure we engage investor/customers in a unified and consistent way.
  • Lead the operating rhythm for Evio's bi-weekly Customer Advisory Committee. Develop agendas, coordinate executive participation, prepare materials and narratives, capture decisions, and drive timely follow-through. Ensure CAC input informs Evio's strategic priorities.
  • Coordinate customer engagement across Evio. Partner with other Evio product teams to clarify ownership, connect the right experts to customer needs, streamline communication, and reduce unnecessary demands on investor/customer health plans.
  • Track adoption, value, and customer insights, particularly related to our work in medication contracting with pharmaceutical manufacturers. Gather and synthesize how investor/customers are adopting Evio's medication contracts and the value they are realizing. Partner with the pharma contracting team to identify opportunities to increase customer value.
  • Strengthen customer relationship management. Build cross-functional processes that improve internal visibility and coordination across customer relationships and activities. Help implement CRM software and processes to track and support customer initiatives.
  • Support annual investor/customer business and financial planning. Coordinate Evio's products, services, value proposition, demonstrated impact, and financial investment requests into a clear, compelling annual customer offering and budget.
  • Create executive and customer communications. Develop on-brand presentations and narratives that make complex information clear and actionable for senior internal and external audiences.

Your skills and experience

  • Education: Bachelor's degree in business, healthcare administration, pharmacy, or a related field. Advanced degree is a plus.
  • Healthcare experience: 7+ years of progressive healthcare experience, including direct experience working with or supporting health plans. Pharmacy, PBM, or health plan pharmacy experience is strongly preferred.
    • Strong understanding of the health plan landscape and priorities of senior health plan leaders, including Chief Pharmacy Officers and Vice Presidents of Pharmacy.
  • Executive forums: Experience supporting executive governance bodies, advisory councils, boards, or similar forums, including agenda development, executive communications, meeting preparation, and follow-through.
  • Relationship building: Strong executive presence and ability to build credibility with internal teammates and senior investor/customer leaders.
  • Communication and storytelling: Excellent written, verbal, and presentation skills, with particular strength in executive storytelling and presentation development according to brand standards.
  • Organization and execution: Strong project management skills, with the ability to manage competing priorities and bring structure to ambiguous work.
  • Adaptability and resilience: Resourceful, curious, and comfortable shifting between different types of work and taking on unfamiliar challenges as priorities evolve.
  • Exceptional problem solving: Critical thinking and problem-solving skills, with the ability to quickly bring structure to complex and ambiguous challenges, connect insights across customers and teams, and develop thoughtful, actionable solutions for customers. Uses sound judgment to balance customer needs, stakeholder perspectives, and business priorities.

Salary considerations

Anticipated annual base pay range: $120,000-$140,000 plus additional variable compensation.

At Evio, we're committed to building a competitive compensation package to honor the value our teammates bring as well as attract and retain top talent that is aligned with our culture, mission, and values. Compensation includes base pay (range shown) and could include other variable compensation opportunitiesdepending on job seniority, location, and date of hire.   

Please note that the base pay information shown is a general guideline for the job responsibilities and qualifications listed. Salary decisions are based on candidate experience, and market and business considerations.

Evio Benefits:

  • Great Health Insurance
    The company pays 100% of medical, dental, and vision premiums for teammates, and 50% for dependents.
  • 401K Match
    Evio matches 100% of teammate contribution up to 5% of salary, subject to IRS limits. 
  • Time Off
    We have a flexible vacation policy for teammates to unplug and recharge when you need it. There is no minimum or maximum amount of vacation allowed per year, and there is no payment in consideration for unused vacation. Vacation is to be used at your discretion, with approval of leadership.
  • Parental Leave
    Generous paid leave for new parents (includes birth and non-birth parents).