President Medicare Markets - Florida
Vacancy expired!
President Medicare Markets - FloridaLocation: United StatesNewRequisition #: PS33312The President of Medicare - Florida has primary responsibility to be the
vision leader for the fiscal, operational, legislative, regulatory, and
profitable growth objectives in adherence with corporate policies, procedures,
state regulations and laws that govern the areas within Florida. The ideal candidate willleverage resources and partnerships, internally
and externally, to spearhead Anthem’s Government Business Division efforts to
address the needs of our aging population, providing direction for high quality
of care and continued business growth.Responsibility for
this role includes Simply Healthcare and HealthSun aimed at delivering
meaningful solutions to consumers, the communities served, its care providers
and federal agencies. The position oversees strategy, financial performance,
growth and operational execution across assigned Medicare health plans, provider
partnerships and Alliance/JV collaborations, serving over 115,000 members in
Anthem communities.KEY RESPONSIBILITIESAchieving
Annual Operating and business objectives aroundoperatinggain, growth, cost of care commitments, revenue, and meetingor
exceeding quality and accreditation goalsare
central to success, and this position will:
Refine and execute the central region Medicare strategyto meet growth and financial performance to support Anthem’s overall valueproposition- driving top-line and bottom-line growth, ensuring course correctionsare taken to drive continued profitability and long-term viability.
Drive initiatives and innovation across Florida footprintto improve cost of care and quality of care/outcomes for members, providerpartners, governmental partners and other key stakeholders
Createand lead initiatives resulting in improved customerretention, improved competitive positioning and increased customer and earningsgrowth, in part throughdriving operationalexecution anddevelopment of strong brand reputation in themarketplace and community
Ensure networkstrategies and relationships with provider communities support all productlines in terms of cost, quality outcomes, consumer access, and marketcompetitiveness
Manage and growhighly effective risk provider network
Create a high performing team where direct reports andshared services partners are accountable to exchange knowledge, information andbest practices related to Government business to ensure financialgoals/objectives are attained through increased operating performance across theFlorida Medicare footprint and products
Collaborate and coordinate with leadership in other linesof business within Anthem to ensure optimal organizational efficiencies acrossall functional disciplines
Be the face to providers, brokers and regulators for theFlorida Medicare plan
Actively participate in the political and legislativeprocesses, and provide leadership and direction relative to contractnegotiations. Ensure highly productiverelationships and partnerships for the benefit of the organization
Develop andimplement regional and local contract structures and reimbursement methods toalign with provider network to improve the measureable performance of themarket and improve the quality of care for healthmembers. Maintain these relationships to improve total medicalcost and position the market and matrix partners for growth opportunities
Develop, manage and provide oversight of key regulatoryand legislative relationships and processes, including premium rates, coveredpopulations, eligibility, benefit design, networks, administrativerequirements, and new products. Represent the Medicare business unit atlegislative sessions, committee meetings, policy meetings and other functionsas needed
Provide oversight of the risk management program,including fraud and abuse program compliance and reporting responsibility. Identifythreats to financial assets, reputation, and human resources
Educate and influence stakeholders in prospectingbusiness opportunities and best practice sharing. Seek and develop businessendeavors that have a value proposition for the region. Leverage assets,resources and expertise in current health plans, and collaborate across theorganization
Additionally,
the ideal candidate will:
Promote organizationalculturalvalues and behaviors.Ensure regular coaching, timely performancemanagement and active mentoring. Assessand develop bench strength and retain talent in accordance with associateretention and development goals.
Ensure Sarbanes-Oxley (SOX)compliance and meet other key manager goals and metrics.
Manage and participate in thedevelopment of growth strategies, branding and retention initiatives
Direct and participate inrelationships with key hospital systems, large physician practices/clinics andkey ancillary providers such as dental and vision contractual relationships inregion.
Oversee internal communicationsensuring support for company values, liaison with corporate personnel andexternal communications with the State, providers, members, community groupsand the media.
Oversee corporate shared/supportservices and service operations interface with health plans.
Assist with and/or lead corporateprojects, acquisitions, and due diligence initiatives.
PROFESSIONAL EXPERIENCE/EDUCATION
Bachelor's degree in a related field(Master's preferred)
Deep understanding of the risk environment
Ability to operate at the strategic and tacticallevels in sales, network, operations and technology for 24x7 member and partnersupport
Minimum of 15 years in program healthcareand/or integrity-related field, and 5+ years’ executive level experience orP&L responsibility
Experience working in a seniorleadership position for a managed care organization preferred, ideally withspecific public sector managed care experience
Comprehensiveknowledgeof HMO/Healthcare systems and to improve quality of care and reduce costs
Strong financial management,organizational, negotiation, analytical and management skills
Highly effective interpersonal andrelationship building skills
Prior success in a fast-paced environment andfollow-through management style
Strong work ethic, keen performanceorientation, along with an appreciation and embrace of the company’s missionand member population
Demonstratedsuccessful leadership skills in programmanagement, program execution, people management
Successfulleadership and management experience buildingeffective teams, managing cross functional teams, and continuous improvement/staff developmentprograms
Demonstrated superior oral/writteninterpersonal communication, persuasion, and negotiation skills
Strategic thinking and demonstratedorganizational leadership capabilities required
Key skills include analytical ability,innovation and creativity, teamwork and communications
Ability to successfully interface at alllevels with the customer, industry, and corporate entities
Vacancy expired!