Regional VP FL Long Term Care Plan

Profile

Description

The Regional VP manages the development, operations, and results of a health plan. The Regional VP requires a in-depth understanding of how organization capabilities interrelate across segments and/or enterprise-wide.

Responsibilities

We are seeking an experienced leader with a deep background in health plan operations across key areas of health plan management. This role has P&L responsibility for our Florida Long Term Care (LTC) business serving approximately 28,000 members statewide. The successful leader will oversee Strategy, Clinical Model of Care, Process Improvement, Utilization Management, Network and the operational dynamics of Humana's Florida LTC health care program. The RVP, Market Leadership for Florida LTC will focus on deepening relationships with our state partners, members, providers, and industry associations. He/she will utilize his/her expertise in delivering care in the home to improve quality outcomes through innovative clinical models, strategic provider relationships, and community resources for vulnerable and underserved individuals.

Job Functions:

Customer Relationship Management


Manage day-to-day business inquiries and ongoing relationship management support for AHCA with regard to Long Term Care program services.
Provide external leadership and collaboration with LTC network associations, local areas on aging, lead agencies and community based organization partnerships
Demonstration of compassion & passion for vulnerable populations


Financial Acumen and Management


Demonstrated experience managing administrative expense, unit cost management and utilization management with respect to clinical and/or LTC care delivery services.
Sound financial management and achievement of annual budgetary objectives, including development and execution of trend management initiatives.
Profit & Loss accountability for Long Term Care program services
Understanding of trends and mitigation; ability to execute on profitability strategies


Operational Compliance & Business Process Oversight


Day to day oversight and accountability for the overall performance and operational success of the LTC product
Develop strategies and objectives for long term care consistent with the mission and philosophy of Humana
Display a commitment to quality and innovation


Leadership and Associate Engagement


Demonstrated servant leadership skills and experiencing managing large business teams of 100 FTE roll-up.
Personal accountability and commitment to continuously improve the associate experience


Required Qualification:


Bachelor's Degree
2-3 years progressive leadership experience in a clinical setting
Service delivery and/or care management experience in a Long Term Care setting (Nursing Facility, Long Term Acute Rehabilitation, Assisted Living Facility)
A minimum of 5 years of experience working directly with Medicaid and or Medicare programs
Statewide oversight, Person will be based in Tampa FL (office based job post pandemic)
40% travel within the state of FL
NOTE: LTC can be interchangeable with LTSS (Long Term Support Services) experience


Preferred Qualifications


Minimum 2 year experience with the Long Term Care provider and payor side
Master's Degree
Proven track record of driving operational performance improvement
Proven experience developing multi-product strategy at the market level or higher.
Excellent verbal and written communications skills
Experience leading the end-to-end contract negotiation process through closure for all types of providers (physicians, hospitals, post-acute care facilities) and delegated specialty services.
Comprehensive knowledge of health plan finance and the compensation arrangements between health plans and providers
Knowledge of risk arrangements and ability to influence these arrangements.
Solid track record of hiring and developing talent and preparing associates for roles of broader and greater responsibility
Must be passionate about contributing to an organization focused on continuously improving consumer experiences


Scheduled Weekly Hours

40

Company info

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