Executive Director, Third Party Administrator Services - CFHP

University Health; San Antonio (TX); On-site; USD 180,000 - 240,000; Full time

Job summary

Community First Third-Party Administrator Services, Inc. seeks an Executive Director to lead the TPA portfolio within CFHP, directing strategic, operational, and financial performance.

The role requires building a high-performing leadership team, ensuring compliance with Texas insurance regulations, and driving growth in claims administration, provider network management, enrollment, and regulatory reporting for managed care clients.

Qualifications

• Bachelor's degree required; 10+ years leadership/health plan ops preferred.
• Experience with health plan operations, TPA services, or managed care.
• Exposure to Texas Insurance regulations and licensing is highly desirable.

Responsibilities

• Lead strategic, operational and financial performance of the TPA Services.
• Build and guide a high-performing leadership team across departments.
• Ensure regulatory compliance and reporting for managed care clients.

Skills

Leadership experience

Strategic planning

Regulatory knowledge

Education

Bachelor's degree

Job description

Executive Director, Third Party Administrator Services - CFHP

Responsible for the strategic, operational, and financial performance of the Community First Third-Party Administrator (TPA) Services, Inc., organization, ensuring strong compliance, operational excellence, and market growth in alignment with Community First’s mission and long term diversification strategy. Build, oversee and collaborate with other department leaders, to ensure the success of the TPA’s administrative service portfolio, including claims administration, provider network management, enrollment and eligibility services, regulatory reporting, and member services, positioning the TPA Services organization as a trusted, high performing partner for managed care organizations and health plans.

EDUCATION/EXPERIENCE

A bachelor’s degree is required. A minimum of 10 years of progressively responsible relevant experience will be accepted in lieu of educational requirements. The ideal candidate will possess a minimum of 8 years of progressively responsible leadership experience in health plan operations, third party administration, managed care, or a related healthcare services environment, along with demonstrated success in building or managing a TPA Services organization, health plan operations department, or similar administrative services function. Experience with Texas Department of Insurance (TDI) regulations and TPA Services licensing is highly desirable, as we