Remote - Dual Eligible Programs President - R6289

Job Summary
The Dual Eligible Programs President is responsible for leading and collaborating with the Market leadership team(s) to establish strategic and operational goals, including optimization of quality and STARs performance measures, for the Market(s) and/or specific product(s).
Essential Functions

• In partnership with the President, Market, establish and maintain strong cooperative working relationships with regulatory agencies and state legislators
• Responsible for influencing rate setting, risk adjustment engagement and quality financial outcomes
• Perform any other job duties as requested
• Ensure compliance with the contract with the state or Commonwealth
• In support of the President, Market, works to build board objectives and agendas and messaging for quarterly meetings.
• In partnership with the President, Market, develop annual operating budget in conjunction with Enterprise services; monitor the financial activities of the plan including budgeting and forecasting to ensure financial goals are met
• Recruit, develop and lead key staff
• Develop and implement operational policies and procedures
• Responsible for plan and/or product performance/health plan P&L, including but not limited to, maintaining and growing market share, meeting operational and membership targets, maintaining or improving customer satisfaction ratings, and enhancing quality and HEDIS results (NCQA)
• Responsible for the strategy and execution to transition the Company’s Medicare-Medicaid plan (MMP) to an integrated Medicare Advantage dual eligible special needs plans (D-SNP)
• Oversee and monitor physician and provider contracting and on-going relationships with the plan’s physician and provider network
• Work with the organization to coordinate the delivery of all required operational services
• Ensure the plan is customer and quality driven, and at the same time, develop or participate in a continuum of care responsible to members’ needs
• Lead local strategy efforts and operational planning; provide oversight of all plan operations
• Coordinate and monitor the activities of the plan Medical Director in conjunction with the Corporate Medical Director leadership

Education And Experience

• Experience leading an organization through start up growth phases and/or new joint venture partnerships
• Depth in governmental product design and experience working with underserved populations
• A minimum of five (5) years leading division and corporate initiatives is required
• Senior Leadership experience, with a minimum of five (5) years of experience in a managed care setting (preferably Medicaid/Medicare) is required; preference to candidate with health plan experience as a Plan President/Senior Executive
• Extensive experience leading large, diverse teams to successful outcomes
• Bachelor’s degree in finance, business, healthcare or other related field is required; Master’s in Business Administration, Healthcare Administration and/or other related discipline is preferred

Competencies, Knowledge And Skills

• Effective communication, presentation skills and board presentation experience
• Commitment to the mission and values of the CareSource Family of Companies
• Strong understanding of healthcare finances and medical economics
• Strong collaborative skills, working with cross-functional stakeholders and external partners including state agencies, elected officials, community partners and business leaders
• Understanding of Medicare/Medicaid/Exchange/Special Populations’ regulatory environment
• Acumen in strategic positioning, infrastructure development & design and proven ability to introduce new products

Licensure And Certification

• None

Working Conditions

• General office environment; may be required to sit or stand for extended periods of time
• May be required to travel locally and nationally

Compensation Range
$150,000 - $300,000. The actual salary will vary based on applicant’s education, experience, skills, and abilities, as well as internal equity and alignment with market data. The salary may also be adjusted based on applicant’s geographic location.
Compensation Type
Salary