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VP, Medicaid Programs

Job Category: Executive

Location: New York, NY, United States

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Job Description

Description

The Vice President (VP), Medicaid will have overall leadership, direction, growth and profit/loss responsibility for Healthfirst’s Medicaid line of business. Medicaid generates approximately $7B in premium revenue annually and covers 1.1M members. This role includes market intelligence, product strategy (revenue, acquisition, & retention), implementation and management for Medicaid products across Healthfirst’s existing and future catchment area.

The Vice President, Medicaid will act as the general manager for this product group focused on researching, developing, implementing and managing the Medicaid Market products for Healthfirst with a strategic plan for growth through 2022. These responsibilities include active analysis of market trends and opportunities (segmentation & targeting) and clear understanding of customer value propositions to differentiate Healthfirst in the marketplace; also, critical knowledge and management of a portfolio of products, the network breadth, cost and potential pricing of recommended products and sales. This will necessitate a strong partnership with finance, legal, compliance, underwriting, claims and other administrative functions/partners to influence all aspects of the market positioning, product development and implementation. This individual will establish new product development priorities and serve as the thought leader on this market/ product set.

Specific responsibilities include:

  • Profit and loss accountability for the Medicaid business. Ensure that market segments are meeting growth and profitability targets at the product and geographic level. Work closely with actuarial, operations, medical management, compliance and marketing/ communications functions to ensure planning and execution of the product strategy.

  • Manage current product portfolio while working with current payers to develop new market/product offerings in the Medicaid market space.

  • Drive segmentation and targeting strategies and value proposition to ensure sales growth. Provide leadership and direction to the sales team, develop critical relationships in the marketplace and collaborate cross functionally to ensure the sales teams are considered a strategic differentiator within the market.

  • Review product performance; drive strategic direction of the product set within the portfolio strategy, and achieve revenue and applicable profitability targets. Develop an annual market plan.

  • Partner with pricing actuaries to ensure strategic pricing of the products and strong understanding of profitability drivers and metrics.

  • Implement and manage product set portfolio.

  • Establish strong understanding of product performance and lead systematic, performance reviews.

  • Partner with Legal and Compliance on legislative and regulatory topics impacting the Medicaid line of business.

  • Drive innovation for an assigned set of products including establishing product development priorities and developing solutions-oriented products and capabilities informed by field, market and consumer research.

  • Competitive intelligence including on-going market performance monitoring to maximize competitiveness while ensuring product standardization and administrative consistency.

  • Bringing together the aggregation of market research, finding needs of the marketplace using product performance analytics to develop new Medicaid products and services and drive modifications to existing products that expand Healthfirst’s market penetration in target markets.

  • Creating and exploring future business strategies based upon emerging trends and assessing market opportunities and threats. Using market insight, develop multiple scenarios and product concepts to favorably position Healthfirst in the New York market.

  • Identify internal and external best demonstrated practices and ensure that skillsets and capabilities exist within the team to execute the strategy.

  • Provide coaching and feedback to staff to ensure ongoing individual/team development and the attainment of performance objectives. Attract, develop and retain the best team in the industry.

  • Provide leadership through transformational change.

Professional Experience / Qualifications:

The Vice President, Medicaid will have demonstrated experience in progressive management in marketing and product management in the Government Programs health plan space. S/he will have strong management and leadership capabilities and, ideally, an astute understanding of the NYC managed care market and urban healthcare delivery networks. An understanding of the linkages between market leadership and product development in these environments is important as is strong business acumen, negotiation, financial management and analytical skills.

Additional qualifications include:

  • Extensive experience in product development and working with finance, legal, compliance, underwriting, claims and other administrative functions/partners.

  • Strategic and business transformation experience focusing on people, process and structures.

  • Demonstrated ability to work collaboratively with staff across the organization while maintaining the ability to be decisive and forthright in a consensus-driven professional environment.

  • Experience managing multiple external and internal business processes and systems.

  • Ability to thrive in a fast-paced, entrepreneurial environment that is continually seeking to refine and improve upon processes and systems.

  • Strong strategic leadership skills. The ability to assess the current healthcare marketplace while simultaneously setting goals and contributing to the vision that maintains Healthfirst’s competitive edge and unique marketplace niche.

  • Exceptional interpersonal, communication and presentation skills.

  • Ability to establish relationships with a broad spectrum of community and national healthcare professionals through presentations, meetings, conferences and associations.

Education:

A Bachelors Degree is required and a Masters Degree is preferred.

Minimum Qualifications:

  • Demonstrated experience in progressive management in marketing and product management in the Commercial health plan industry
  • Strong management and leadership capabilities.
  • An astute understanding of NYC managed care market and urban healthcare delivery networks. Understanding the linkages between market leadership and product development in these environments.
  • Strong market knowledge, business acumen, negotiation, financial management and analytical skills
  • Extensive experience in product development and working with finance, legal, compliance, underwriting, claims and other administrative functions/partners
  • Strategic and business transformation experience focusing on people, process and structures.
  • Bachelors Degree from an accredited institution

Preferred Qualifications:

  • Demonstrated ability to work collaboratively with staff across the organization while maintaining the ability to be decisive and forthright in a consensus-driven professional environment.
  • Experience managing multiple external and internal business processes and systems.
  • Ability to thrive in a fast-paced, entrepreneurial environment that is continually seeking to refine and improve upon processes and systems.
  • Strong strategic leadership skills. The ability to assess the current healthcare marketplace while simultaneously setting goals and contributing to the vision that maintains Healthfirst’s competitive edge and unique marketplace niche.
  • Exceptional interpersonal, communication and presentation skills.
  • Ability to establish relationships with a broad spectrum of community and national healthcare professionals through presentations, meetings, conferences and associations.
  • Master’s Degree

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

If you have a disability under the Americans with Disability Act or a similar law, and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to [email protected] or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.

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