Vice President, Virginia Medicaid Plan President

City/State

Virginia Beach, VA

Overview

Work Shift

First (Days) (United States of America)

Virginia Medicaid Health Plan President

Location: Virginia

Reports To: Executive Vice President and President of Sentara Health Plans

Summary: The Vice President and Medicaid Health Plan President for Sentara Health Plans is the visionary leader responsible for the long-term success and sustainable growth of our Virginia-based organization providing vital health coverage to Virginia's Medicaid beneficiaries. This critical role requires a passionate advocate for health equity, coupled with strategic expertise in navigating the complexities of Virginia's Medicaid program and leading the organization through dynamic regulatory and healthcare environments. The ideal candidate will champion the needs of our members while cultivating strong partnerships with state officials, providers, and community organizations.

Key Responsibilities:

· Strategic Leadership: Develop and implement a strategy for the health plan's growth and success, ensuring alignment with Virginia's Medicaid program regulations and addressing the unique needs of the underserved population.

· Medicaid Expertise: Possess a deep understanding of Virginia's Medicaid program framework, including eligibility criteria, financing models, provider network management, and program regulations.

· Operational Excellence: This position involves leading a management team of direct reports and shared services staff and managing within a matrix environment. This position is accountable for all aspects of plan operations, ensuring quality, cost-effectiveness, and a positive member experience.

· Financial Oversight and Sustainability: Oversee the financial health and sustainability of the Medicaid plan. Manage budgets, revenue projections, resource allocation and ensure fiscal responsibility and compliance with regulations.

· Advocacy and Collaboration: Advocate for Medicaid program improvements and access to quality healthcare for underserved communities. Collaborate with government agencies, community stakeholders, and healthcare providers to enhance program effectiveness.

· Member Services Excellence: Ensure exceptional member experiences and satisfaction. Lead efforts to address member concerns, resolve issues promptly, and provide accessible support resources.

· Compliance and Policy: Ensure strict adherence to all federal and Virginia state Medicaid regulations, including data privacy and security measures. Proactively monitor legislative changes and adapt strategies accordingly.

· Growth and Innovation: Actively pursue growth opportunities through market expansion.

· Public Image: Serve as the public face of the organization, fostering community partnerships and engaging media to promote the importance of Medicaid and its role in improving public health outcomes.

Qualifications:

Education:

· Bachelor's degree in related field required

· Master's degree in Business Administration, Public Health, Healthcare Administration, or a closely related field preferred

Experience:

· 10+ years of progressive leadership experience in the healthcare industry, with a minimum of 5 years at a senior executive level within a Medicaid managed care environment.

· Demonstrated success in strategic planning, financial management, operations optimization, and regulatory compliance.

· Thorough understanding of Virginia's Medicaid program, policies, and healthcare delivery systems.

· Exceptional communication, interpersonal, and negotiation skills, with the ability to build trust and consensus among diverse stakeholders.

· Unwavering commitment to promoting health equity, addressing social determinants of health, and improving the health and well-being of Medicaid beneficiaries.

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Job Summary

The VP, Medicaid Plan President is Sentara's expert resource regarding the MLTSS beneficiaries. The VP, Medicaid Plan President provides leadership and Medicaid long term services and supports expertise to Sentara Health Plans' clinical, provider network, marketing, operations and quality department staff as it relates to MLTSS. Ensures appropriate prioritization of initiatives and resource management to fulfill program goals.

Bachelor's degree in related field required, Master's Degree preferred. Minimum of 5 years' experience in or with Medicaid, disability related programs and/or Long Term Services & Support required. Minimum of 5 years' experience working with Federal and State policy initiatives related to Medicaid populations required. Proven success in leadership of program management, execution and development. Proven success building and leading a cross-functional team

Qualifications: