SVP - Medicaid Divisional Leader

4 days ago

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Humana

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10,000+

Description

• Serve as the Divisional leader, presiding over a portfolio of Medicaid Markets • Ensure consistent and aligned strategic execution, market operations, and best practice adoption across all Medicaid markets. • Responsible to oversee all stages of market maturity, uniting business development, active implementation, and established markets for end to end life cycle responsibility • Lead with a focus on financial performance, quality improvements, and state relationship management • Oversee the Medicaid D-SNP market portfolio consisting of approximately 400k members and 5BN in revenue • Streamline complex interactions with Medicare and Enterprise leadership by providing a single point of accountability for Medicaid D-SNP market performance and strategy • Ensure Medicaid Strategic Objectives are executed effectively across all aligned markets • Monitor and adapt to regulatory changes, implement rate advocacy efforts, and drive strategies for managing quality withhold and unit cost reductions • Oversee Profit & Loss (P&L) management for all aligned Medicaid markets • Collaborate with finance teams and market leaders to develop and execute financial strategies that enhance profitability • Serve as the primary advocate for the organization in each aligned state • Develop and maintain strong relationships with state regulators, policymakers, and other key stakeholders • Lead talent management efforts across aligned Medicaid markets, focusing on building a high-performance culture

Requirements

• Bachelor’s degree in Business, Healthcare Administration, or related field required; advanced degree (MBA, MHA, or similar) strongly preferred • 10+ years of experience in Medicaid or healthcare leadership, with a focus on managing market-level operations, P&L oversight, and state relationships • 8 + years of people leadership with proven success in expanding and elevating the capabilities and performance of a multi-level team and large-scale organization. • Proven ability to lead complex, multi-state Medicaid/Medicare markets and drive consistent execution of business objectives • Strong track record of success in managing Medicaid and/or Medicare and DSNP product strategies, as well as financial improvement initiatives • Demonstrated experience in advocacy, regulatory compliance, and stakeholder relationship management at the state and federal levels. • Strong leadership and team-building skills, with the ability to manage a large, geographically dispersed team and foster a unified organizational culture • Deep understanding of Medicaid and/or Medicare, and DSNP policy, regulations, and market trends • Strategic thinker with excellent problem-solving skills, capable of developing innovative solutions to improve market performance and financial outcomes • Exceptional communication and negotiation skills, with the ability to influence and build relationships with a wide range of internal and external stakeholders

Benefits

• Health benefits effective day 1 • Paid time off, holidays, volunteer time and jury duty pay • Recognition pay • 401(k) retirement savings plan with employer match • Tuition assistance • Scholarships for eligible dependents • Parental and caregiver leave • Employee charity matching program • Network Resource Groups (NRGs) • Career development opportunities