SVP, Managed Care Strategy & Growth

TRISTAR MANAGED CARE INC; Summerville (SC); Hybrid; USD 250,000 - 500,000; Full time

Benefits offered by this job

Remote work option

Job summary

TRISTAR MANAGED CARE INC is seeking a Senior Vice President of Managed Care to provide executive leadership and strategic direction for all Managed Care operations. This role sits on the Executive Leadership Team and shapes long-term growth, performance, and client outcomes.

Responsibilities include overseeing Medical Management, Bill Review, Pharmacy Benefit Management (PBM), and ancillary services; building vendor partnerships; ensuring regulatory compliance and cost-effective solutions;

Qualifications

• Requires a bachelor’s degree; a master’s degree is preferred.
• Proven track record leading large, multi-function teams and $30–$60M business units.
• Strong knowledge of managed care services, vendor negotiations, and regulatory requirements.

Responsibilities

• Develop and execute the strategic vision for the Managed Care division.
• Provide executive leadership and operational oversight for Medical Management, Bill Review, PBM, and Ancillary Services.
• Oversee vendor partnerships, regulatory compliance, and cost-effective service delivery.
• Present performance and strategic recommendations to the Board and executive leadership.

Skills

Executive leadership

Strategic planning

Vendor management

Regulatory compliance

Education

Bachelor's degree

Master's degree preferred

Job description

TRISTAR MANAGED CARE INC is seeking a Senior Vice President of Managed Care to provide executive leadership and strategic direction for all Managed Care operations. This role sits on the Executive Leadership Team and shapes long-term growth, performance, and client outcomes.

Responsibilities include overseeing Medical Management, Bill Review, Pharmacy Benefit Management (PBM), and ancillary services; building vendor partnerships; ensuring regulatory compliance and cost-effective solutions;