25 Feb
President Medicare Markets - Florida
New York, New york city 00000 New york city USA

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!


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