VP, General Manager (TX)

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

Reporting to the Chief of Contracting and Market Management, the Vice President/General Manager role is a critical leadership position responsible for driving market performance and achieving operational excellence in Texas. The primary focus of this role is to meet the market’s key performance indicators and operating targets. The RVP/GM will manage end-to-end market performance, including overseeing P&L performance, market planning, and execution, while fostering effective relationships with key stakeholders across the healthcare ecosystem. To achieve key metrics, the RVP/GM must drive collaboration and hold stakeholders accountable (internal and external).

General Duties/Responsibilities (May include but are not limited to):

• P&L Management: Develop and execute the P&L strategy for North Carolina and expansion markets, ensuring financial targets and MLR of 85% are met or exceeded. Develop and operationalize predictive KPI’s to better forecast and manage responsible markets.
• Operational Excellence: Drive performance in CAHPS, HEDIS, and HOS measures, aiming for 5 STARs, and ensure efficient management of JSAs and AWVs to achieve 85% completion rates.
• Quality and Compliance: Lead initiatives to improve MRA quality and coding accuracy, maintaining compliance with CMS regulations, and achieving targets for quality programs.
• Stakeholder Engagement: Build and maintain strong relationships with physician leaders, health systems, IPAs, and community partners to enhance market performance and strategic alignment.
• Sales and Membership Growth: Direct local sales teams through market leaders to achieve a minimum of 30% net membership growth annually, aligned with market goals and regulatory requirements with a push with aligned quality partners.
• Performance Management: Conduct quarterly business reviews through developed scorecards from provider operations, assess performance metrics, and implement corrective actions to drive improvements across key performance indicators. Work with Health Economics and Contracting teams to analyze contract rate trending impact and anomalies.
• Market Strategy: Develop and refine business plans for North Carolina, incorporating regulatory impacts and changes to support sustainable plan performance.
• Health Plan Oversight: Collaborate with Medical Officers and other departments to manage IPA, medical group, and hospital performance, with a focus on achieving budget and operating goals.
• Utilization and Cost Management: Monitor regional performance, implement standardized performance scorecards, address utilization and cost outliers to enhance overall market efficiency, and promote the use of Alignment Health’s clinical programs.
• Network Management: Analyze, negotiate, and manage contracts with PCPs, specialists, and ancillary providers to optimize network performance and support plan objectives.
• Innovation and Product Development: Partner with product teams to drive innovation, manage the annual bid process, and introduce new initiatives that enhance market competitiveness.
• Medicaid and Dual Eligible Strategy: Develop and launch strategies to drive growth and retention in the dual eligible segment, including Medicare and Medicaid plans.
• Compliance and Governance: Ensure adherence to all health plan compliance requirements in line with CMS regulations, and lead initiatives to improve patient satisfaction and operational complianc

• This role is pivotal in driving market success and delivering value to Alignment Health members by managing financial, operational, and quality performance effectively and sustainably.

Supervisory Responsibilities:

Oversees assigned staff. Responsibilities include recruiting, selecting, orienting, and training employees; assigning workload; planning, monitoring, and appraising job results; and coaching, counseling, and disciplining employees.

Minimum Requirements:

To perform this job successfully, an individual must be able to perform each e