Vice President, Coordination of Benefits (COB) Delivery

Summary

Gainwell Technologies is seeking an experienced and execution-driven Vice President of Coordination of Benefits (COB) Delivery to lead the end-to-end operations for our COB solutions across multiple clients and programs. This executive will be accountable for P&L performance, delivery excellence, operational scalability, product innovation, and quality outcomes across all COB services—including file and data management, eligibility and claims matching, third-party liability identification, recovery operations, and client reporting.

The VP will guide a diverse operational organization and work closely with Technology, Analytics, Shared Operational Services, and client leadership to ensure Gainwell’s COB solutions deliver measurable value, operational efficiency, and world-class service. This leader must have deep expertise in health plan operations, payer coordination rules, recovery operations, and large-scale service delivery.

Your role in our mission

End-to-End Operational Leadership

• Provide executive oversight for all COB operational functions, ensuring timely, accurate, and compliant delivery across the entire service lifecycle.
• Own full P&L responsibility, including budgeting, forecasting, margin management, and performance against financial targets.
• Lead day-to-day operations across intake, file operations, cycle management, eligibility/claims matching, call center workflows, recovery operations, lockbox/payment processing, and invoicing.
• Ensure operational models, staffing, and performance structures support scalability and client growth.

Delivery Performance & Quality Management

• Manage operational KPIs, SLAs, productivity standards, and quality metrics to ensure top-tier delivery performance.
• Implement robust quality assurance, workflow controls, compliance protocols, and continuous improvement practices across all COB functions.
• Monitor production trends, identify performance risks, and implement corrective actions to protect service quality and client satisfaction.
• Drive standardization and automation of COB processes to reduce variability, improve accuracy, and increase throughput.

Product Innovation & Solution Evolution

• Partner with Technology, Analytics & Shared Operational Services partners to evolve COB products, workflows, and service capabilities.
• Identify operational inefficiencies, gaps, and opportunities for enhancement to drive product modernization and competitive differentiation.
• Support roadmap planning for new features, analytic capabilities, automation, and client-driven enhancements.
• Champion innovation initiatives that strengthen Gainwell’s position in the COB marketplace.

Client Leadership & Relationship Management

• Serve as the senior operational executive for COB clients, ensuring transparency, performance accountability, and proactive communication.
• Participate in client governance meetings, performance reviews, and strategic planning sessions.
• Collaborate with Client Relationship Management and Sales teams on renewals, expansions, solution design, and service delivery alignment.
• Act as a trusted advisor to clients on COB operations, performance improvements, and industry best practices.

Team Leadership & Organizational Management

• Build, mentor, and lead high-performing teams across operations, quality, workflow management, and recovery operations.
• Establish workforce planning, performance management, and talent development strategies to support service excellence.
• Foster a culture of accountability, continuous improvement, innovation, and operational discipline.
• Ensure organizational structure and staffing align with demand, client commitments, and business objectives.

Cross-Functional Collaboration

• Work closely with Technology, Data Management, Analytics, Shared Operational Services, and other operational leaders to ensure seamless execution and service delivery.
• Support implementations teams in onboarding and transitioning new COB clients into steady-state operations.
• Partner with Finance, Compliance, and Legal to ensure operational integrity, financial accuracy, and regulatory adherence.

What we're looking for

Required Qualifications

• 10+ years of leadership experience in healthcare operations, COB, TPL, payment integrity, claims operations, or related payer services.
• Proven success leading large operational teams with full end-to-end ownership, including delivery performance and P&L accountability.
• Strong understanding of COB rules, eligibility and claims structures, payer coordination requirements, and recovery operations.
• Experience managing complex operational environments with high-volume workflows and strict performance requirements.
• Demonstrated ability to build and manage KPIs, operational dashboards, quality frameworks, and productivity models.
• Excellent executive communication skills, client-facing experience, and ability to influence cross-functional leaders.
• Ability to travel up to 15% within the United States.

Preferred Qualifications

• Experience with Medicaid, Medicare, or large commercial payer COB programs.
• Background implementing process automation, system enhancements, or operational transformation initiatives.
• Experience supporting or collaborating with product development or solution innovation teams.
• Six Sigma, Lean, or similar process-improvement certification.

What you should expect in this role

• This position is 100% remote, with approximately 15% travel to support key client meetings.

The deadline to submit applications for this posting is January 2, 2025.