Highly regarded integrated health plan is searching for a Health Plan President to oversee the plan's business covering the greater Orlando area and about 20,000 lives. The Health Plan President will have full P&L responsibility, and oversee a team of about 100, with 4 direct reports. He or she will be the key point of contact for all Medicaid/Medicare products and services and government entities.
Our client is only considering candidates with deep Health Plan experience... recent and substantial Medicaid / Medicare Health Plan experience, basically.
What You Need to Be Successful as Health Plan President:
- Bachelors' degree in business, nursing or related field. Advanced degree preferred.
- 10+ years experience in managed care with Medicaid and Medicare experience
- 8+ years management level experience, with P&L responsibilities in the managed healthcare industry, which includes health plan operations.
- Thorough knowledge of managed healthcare principles and an understanding of the US healthcare marketplace, issues and trends.
- Deep understanding of financial and quantitative information and a track record of accomplishment in managing operational budgets
- A track record of accomplishment in developing effective teams, resolving conflicts and building collaboration among all levels in the organization.
- Proven negotiation skills
The Health Plan President will:
- Manage financial performance, operating budget and variances from plan to ensure cost effective delivery of service.
- Develop and implement annual operating budget.
- Oversee compliance for all operations performance standards, develop and manage action plans to bring back to compliance when standards are not met.
- Develop service level agreements with account management.
- Direct administrative and infrastructure operations activities which could include lease negotiations, staffing plans, supervision of non-clinical staff, telephone systems, etc...
- Oversee all area clinical and operations staff including recruitment, hiring, promotion
- Direct the delivery of high-quality services within the site and ensuring quality management plans and protocols are implemented and services are delivered in accordance with policies and procedures.
- Monitor quality assurance indicators and provides quality oversight.
- Manage high-risk cases and utilization trends.