Vp, Medicaid Regional President Sc

R-303509
Description
Humana’s South Carolina Medicaid State Market Leader will be responsible for the overall strategic direction, oversight, and administration of programs and services for our Medicaid program in South Carolina. They will lead the Humana South Carolina Medicaid executive team and report directly to Humana’s SVP, Medicaid Divisional President. The State Market Leader will be based in South Carolina and will be the primary contact for the South Carolina Department of Medicaid Services regarding all issues and will coordinate with other key personnel to fulfill programmatic requirements. They will publicly represent Humana Medicaid in South Carolina while enhancing and further developing relationships with stakeholders throughout the state.
Responsibilities
The VP, Medicaid Regional President manages the development, operations, and results of a health plan and requires an in-depth understanding of how organization capabilities interrelate across segments and/or enterprise-wide.
Essential Functions And Responsibilities

• Manage executive Medicaid leadership team in the South Carolina market, through which all plan associates report
• Develop and adhere to budgets
• Represent Humana to the public, to plan members, to associates, to South Carolina Department of Medicaid Services, and to subcontractors
• Develop strategies, formulate policies, and oversee operations to ensure the appropriate objectives and goals are met
• Ensure long-term health plan financial success, sustainability, and growth
• Promote a culture of health and well-being throughout the organization
• Ensure plan compliance with federal and state laws and programmatic requirements, including fraud, waste, and abuse; make decisions in an ethical manner
• Resolve urgent and emergency matters in a fair way according to applicable policies and procedures
• Develop clear and measurable plan objectives, goals, and ideas
• Oversee operational policies and procedures
• Drive a focus on the delivery of high-quality care and supports
• Work with Humana National support teams to infuse best practices from other states and drive new ideas and initiatives from across the Medicaid and healthcare industry
• Serve as chairperson of the Member Advisory Council
• Establish and maintain a diverse, inclusive, and respectful environment
• Effectively support the growth of associates to enhance plan leadership and career development

Required

• Bachelor’s degree in Business, Healthcare Administration, or related field
• SC residence

Preferred Experience Qualifications

• Six (6) to ten (10) years of experience working in healthcare or government leadership and/or operations management
• Master’s degree in Business, Healthcare, Public Health, or related field
• Experience in Medicaid MCO plan operations; experience in strategic and thought leadership in supporting Medicaid health plans; experience with budgeting and financial management of a health plan
• Leadership background with more than five (5) direct-reports
• Experience working with Long Term Care Services and Support (LTSS)

Additional Information

• Travel 25%
• Ability to go into office as business requires

This is a remote position
Scheduled Weekly Hours
40