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Health Plan Operations

NYC (Hybrid)
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About Taro Health

Taro Health is a team of healthcare nerds, software engineers, product designers, direct primary care doctors, health insurance experts, and more. We are building a healthcare system that makes sense, starting by redefining the role of health insurance – one that focuses on reducing friction for doctors and patients, and investing in ways to create more meaningful doctor-patient relationships. 

We believe unrushed conversations with doctors lead to better health and lower costs for patients. Our health plans enable all members to have free and frictionless access to a dedicated doctor they know and trust. We’re excited to create health insurance plans you can actually use.

We’re backed by top investors and are looking for values-aligned individuals to join our NYC-based founding team.

Our aspirations for this role

Taro Health is seeking an experienced and enthusiastic day-to-day health plan operations lead. For the right candidate, this is a tremendous opportunity to grow professionally by covering a broad surface area of health insurance operations. Wearing multiple hats is an understatement, but you should feel energized by that level of scope and responsibility.

You will be deeply involved in all operational matters that’s required in running a health insurance company and delivering on member expectations of their plan benefits. This includes, but is not limited to, owning escalated member and provider issues to resolution, managing key external partners like our TPA, PBM, and utilization management vendor, coordinating and developing internal operational processes, tracking vendor reporting including KPIs and SLAs, overseeing contracts for Taro’s vendor partners, collaborating on network-related issues, and leading health plan operations strategy and the overall member experience.  You love getting into the weeds.

Taro Health is in its early stages. Each new team member has the opportunity to significantly shape our culture, product, strategy, and operations. Candidates should be eager to work in a dynamic, fast-moving environment where their contributions have a direct and outsized impact.

Let’s dive into the details

In this role, you will:

  • Embrace being the company’s health plan operations lead, working with both external partners and directly communicating with Taro’s members and providers on escalated issues
  • Define and manage KPIs and metrics related to day-to-day health insurance operations 
  • Collaborate closely with our external operational partners, including our TPA, PBM, vision, telehealth, and utilization management vendors  to ensure that they are delivering on contract requirements and supporting Taro members and providers effectively. We program manage and treat these partners as if they were internal team members.
  • Lead root cause analysis and issue resolution, then share learnings and implement improvements
  • Be comfortable and flexible with non-scalable processes to start, while working with internal and external partners to develop high-leverage scalable processes to enabling Taro’s growth and efficiency
  • Build out the necessary customer support/success and operations teams over time, as you will have seen these issues first-hand
  • Support Taro developers with technology buildout and data processing by providing business context and subject matter expertise
  • Partner with finance and accounting to support reconciliation and strategic financial planning

Experience that excites us

Education, experience, and certifications

  • Bachelor’s degree
  • Experience in an operations or customer success/support role, ideally from a previous startup
  • Experience in healthcare, ideally in health insurance

Knowledge, skills, and abilities

  • Knowledge of health plan operations and the entire healthcare ecosystem, including understanding of medical and pharmacy claims processing, networks, customer service, and health plan rules and regulations. 
  • Experience using a CRM or help desk platform for tracking issues and their resolution (Zendesk, Salesforce, etc.)
  • Data analytics 
  • Proficiency in Google Suite tools

You will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Taro’s employee benefits include:

  • Unlimited PTO
  • Flexible work - hybrid or remote
  • Health insurance contribution (via ICHRA)
  • A DPC membership!
  • Dental benefits
  • 401k

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