Hiring: Vice President of Health Plan Operations and Claims Company: Prime Healthcare Location: Ontario, CA Job Posted Time: 2026-09-10 07:38:56 Employment Type: Full-time About the job Experience: •Including PDR's, Disputes, Appeals and Recoveries. Sound intriguing, then you will be thrilled to know we offer very Required Skills: •This position requires relocating to Ontario, California. •Vice President of Health Plan Operations and Claims •Including designing •, performance management techniques and metrics. Someone with significant Qualifications: •Master’s Degree in Business Management, Healthcare Administration, or other relevant fields. •A minimum of seven (7) to ten (10) years prior work experience in Claims Operations and Health Plan Strategy, in a Managed Care, Self-Funded or hospital setting is required. •Analytical skills with emphasis on generation and utilization of data to drive operational and financial performance. •Demonstrated capacity to work in a complex, rapidly evolving environment with multiple internal and external entities and boundaries. •Strong interpersonal skills, problem solving and project/time management essential. •Demonstrated capacity to develop presentations to all levels using Microsoft Office applications. •Strong knowledge of medical coding (ICD-10, HCPCs/CPT, etc.) •Certified Professional Coding Certification, AIC, ARM, or equivalent. •Operational familiarity with multiple Business Intelligence software systems and daily usage of at least one. •At Prime #Healthcare, our employees #wellness is important. We're looking for our next #healthcareleaders or #healthcareprofessionals to guide our #healthplan. This position should be a part of your #jobsearch, we're #hiring and this is a rewarding #jobs. Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!