VP, Member Orchestration Architecture & Design

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

The VP, Member Orchestration Architecture & Design is the lead executive responsible for defining and advancing Alignment Healthcare's future-state member experience. The role owns the member experience strategy, journey architecture, innovation roadmap, digital and AI transformation portfolio, outbound activity, and governance model. Working across member touchpoints, this leader identifies friction, designs future-state experiences, develops investment business cases, and drives measurable improvements in member satisfaction, quality outcomes, operational efficiency, and long-term growth. The position reports to the SVP, Customer Experience Member Operations and leads cross-functional transformation across Member Services, Appeals & Grievances, Clinical Operations, Care Management, Marketing, Stars & Quality, Product, DTS/Technology, and Operations.

Job Duties/Responsibilities:

CX Strategy & Transformation Leadership

·       Develop and execute an enterprise CX transformation roadmap focused on digital, AI, automation, self-service, personalization, and omnichannel engagement.

·       Establish the future-state member experience vision aligned with organizational growth objectives.

·       Create strategic business cases, investment justifications, ROI analyses, and capital expenditure proposals for executive leadership approval.

·       Lead cross-functional transformation initiatives from concept through implementation and value realization.

·       Identify industry trends, competitive benchmarks, and emerging technologies that can improve member outcomes and operational performance.

Member Journey & Touchpoint Blueprint

·       Own and maintain comprehensive current-state and future-state member journey maps, identifying friction points, service failures, moments that matter, segmentation and personalization opportunities, service recovery pathways, and improvement priorities.

·       Institutionalize the Alignment Moments that Matter framework so critical member interactions are intentionally designed, measured, governed, and improved.

·       Deliver enterprise journey maps, experience gap assessments, journey scorecards, opportunity prioritization matrices, customer-effort reduction recommendations, and member outreach strategies.

Service Design & Experience Engineering

·       Design future-state member experiences and service blueprints.

·       Redesign member-facing workflows, simplify complex processes, and reduce effort across service channels.

·       Align people, process, policy, technology, and AI within an integrated experience framework.

Digital & AI Innovation Leadership

·       Lead the identification, evaluation, design, piloting, implementation, and scaling of conversational AI, generative AI, AI agents and agentic workflows, intelligent outreach platforms, contact center AI, care navigation tools, predictive analytics, digital self-service, personalization engines, and automation technologies.

·       Build and deploy AI agents and internally pilot AI-enabled tools and workflows before member-facing deployment.

·       Own and continuously refine the digital and AI roadmap, prioritizing initiatives based on member impact, business impact, complexity, cost, risk, and strategic value.

·       Define AI governance and responsible AI practices in partnership with enterprise technology, compliance, data governance, and privacy teams.

·       Measure AI adoption, productivity improvement, business value realization, and operational outcomes.

Voice of Member & Experience Insights

·       Develop the enterprise Voice of Member strategy and establish a closed-loop feedback system.

·       Integrate CAHPS, NPS, CTM, grievance, complaint, and contact center feedback into journey improvements.

·       Identify emerging friction points through data, analytics, and member feedback, and translate insights into prioritized transformation initiatives.

Build, Buy & Partner Strategy

·       Assess internal capability gaps and evaluate build, buy, and partnership alternatives.

·       Lead vendor evaluations and RFP processes; identify strategic technology partners and establish selection criteria.

·       Create technology business cases and vendor governance and value-realization frameworks.

·       Evaluate, select, and manage strategic technology and vendor partnerships supporting AI and automation initiatives.

Financial Accountability, Governance & Metrics

·       Own business cases, ROI realization, capital planning, vendor investments, and benefit tracking for transformation investments.

·       Establish CX governance councils, ownership and accountability models, KPI frameworks, executive dashboards, reporting structures, and performance scorecards.

·       Build transformation tracking and portfolio management processes and measure ROI, adoption, satisfaction, member outcomes, operational outcomes, and administrative cost reduction.

Direct & Cross-Functional Leadership

·       Build and lead a team combining hands-on technical development capability with strategic program and vendor management.

·       Direct a specialized team responsible for member journey mapping, AI and digital solution development and implementation, member outreach, and service recovery.

·       Hire, train, coach, manage performance, and administer corrective action in accordance with company policy and regulatory requirements.

·       Drive alignment across Member Services, Appeals & Grievances, Clinical Operations, Care Management, Marketing, Stars & Quality, Product, DTS/Technology and the AI Council, Operations, and Executive Leadership while influencing without direct authority.

·       Produce reports that monitor implementation progress and impact.

Success Measures

Improvement in CAHPS, Stars, first-contact resolution, digital adoption, self-service utilization, and member effort scores.

Reduction in grievances and complaints tied to identified friction points and measurable administrative cost reduction.

AI-enabled productivity improvements and realization of approved business-case ROI.

Enterprise adoption of the journey governance framework and completion of a comprehensive member journey map used across member-facing teams.

Establishment of a prioritized digital and AI roadmap with defined use cases, measurable business impact, successful internal pilots, and scaled deployment.

Job Requirements:

EXPERIENCE

Required:

·       15+ years of leadership experience in customer experience, operations transformation, digital strategy, consulting, enterprise transformation, or a related field.

·       Significant operations leadership experience, including direct experience designing and implementing AI or automation solutions.

·       Demonstrated ability to operate across hands-on technical execution, including workflow design and tool development, and strategic planning, including roadmaps, vendor management, and governance.

·       Experience working in a regulated industry with knowledge of data privacy and compliance requirements related to AI deployment.

·       Strong record of senior-level cross-functional leadership, stakeholder management, and influencing without direct authority.

·       Experience scaling customer experience functions supporting 500,000+ customers or members.

·       Experience leading AI, digital, or contact center transformation initiatives.

·       Experience presenting strategy and investment recommendations to executive leadership and Boards.

Preferred:

·       Experience in healthcare or health plan operations.

·       Experience in Medicare Advantage, payer, provider, financial services, airline, hospitality, or another highly regulated service industry.

EDUCATION

Required: Bachelor's Degree (BA) from four-year college or university, or one to two years of related experience and/or training, or equivalent combination of education and experience.

Preferred: Master’s Degree (MA) preferred.

SPECIALIZED SKILLS

·       Enterprise CX strategy, journey mapping, service design, and operating model redesign.

·       Digital transformation, AI strategy, responsible AI governance, automation, and technology portfolio prioritization.

·       Business-case development, ROI analysis, capital planning, benefit realization, and executive-level storytelling.

·       Voice of Member analytics using CAHPS, NPS, CTM, grievance, complaint, and contact center data.

·       Vendor evaluation, RFP leadership, strategic partnership management, and governance.

·       Ability to convert ambiguous problems and a blank sheet of paper into a strategy, investment plan, operating model, and implementation roadmap.

·       Strong bias for action, urgency, accountability, collaboration, and measurable results.

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to talk or hear and to stand, walk, sit, use hands to finger, handle or feel objects, tools, or controls, and reach with hands and arms.

The employee occasionally lifts and/or moves up to 20 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

This role is primarily remote and requires regular computer use and the ability to travel to Orange, California and Las Vegas, Nevada.

Pay Range: $262,145.00 - $393,217.00

Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email careers@ahcusa.com.