SVP, Health Plan Services

WelbeHealth is a value-based healthcare organization thats transforming the future of senior care by providing an all-inclusive care option to our most vulnerable senior population.

The Senior Vice President (SVP) Health Plan Operations is the strategic and operational leader of WelbeHealths health plan and a critical senior leader for the enterprise as a whole. The SVP Health Plan Operations is accountable for maturing and scaling the WelbeHealth plan to ensure high-quality cost-effective care for participants with high compliance as WelbeHealth continues its rapid pace of growth.

Essential Job Duties:

Oversee health plan operations including strategy execution performance and compliance of all health plan functions as well as participate in and influence strategic planning and broader WelbeHealth initiatives ensuring that the health plan needs and strategy are considered and prioritized appropriately

Build a deep understanding of the PACE model and implications for health plan operations in the PACE context

Demonstrate exemplary financial acumen maintaining a strong relationship and communication with the finance team to ensure alignment planning and shared insight across functions

Owns all end-to-end core health plan processes working with teams to ensure processes are streamlined and optimally designed for scale and tech-enablement

Partner with IT team to co-build and jointly own HPS technology roadmap ensuring WelbeHealth is leveraging technology effectively to scale our health plan operations decrease risk of errors and increase performance

Hire develop inspire and invest in the successful careers of top HPS talent and other key talent in the function

Ensures WelbeHealths beyond reproach compliance with applicable federal state and local regulatory and licensing standards as well as maintain knowledge of the regulatory and external landscape to ensure alignment with best practices

Job Requirements:

Bachelors degree in healthcare administration public health business social welfare gerontology or relevant field; MBA MHA or master-level equivalency strongly preferred

Five (5) years of experience leading a $100 million health insurance function with P&L accountabilities with a consistent track record of driving initiatives that improve operations effectiveness and patient experience

Ten (10) years of relevant professional experience and knowledge of managed care including Medicaid that includes health plan operations medical management clinical review criteria processes and techniques

Experience working with CMS state health and human service department regulators and other government stakeholders

Experience directly leading teams and owning team outcomes across at least three (3) of the four (4) core HPS teams network provider partnerships claims processing and eligibility & reconciliation

Demonstrated ability to hire top talent build high performing teams and mentoring and developing high potential leaders

Must be willing to work a varied schedule that may include evenings weekends and overtime

Preference for a candidate located in or willing to relocate to within an hour of a current or future WelbeHealth location

Benefits of Working at WelbeHealth: Apply your expertise in new ways as we rapidly expand. You will have the opportunity to design the way we work in the context of an encouraging and loving environment where every person feels uniquely cared for.

401k employer match

Medical insurance coverage (Medical Dental Vision) starting day one of employment

Work life balance 17 days of personal time off (PTO) 12 holidays observed annually and six sick days

And additional benefits

Salary/Wage base range for this role is $300000 - 350000 / year Bonus Equity. WelbeHealth offers competitive total rewards package that includes 401k match healthcare coverage and a broad range of other benefits. Actual pay will be adjusted based on experience and other qualifications.

COVID-19 Vaccination Policy

At WelbeHealth our mission is to unlock the full potential of our vulnerable seniors. In this spirit please note that we have a vaccination policy for all our employees and proof of vaccination or a vaccine declination form will be required prior to employment. WelbeHealth maintains required infection control and PPE standards and has requirements relevant to all team members regarding vaccinations.

Our Commitment to Diversity Equity and Inclusion

At WelbeHealth we embrace and cherish the diversity of our team members and were committed to building a culture of inclusion and belonging. Were proud to be an equal opportunity employer. People seeking employment at WelbeHealth are considered without regard to race color religion sex gender gender identity gender expression sexual orientation marital or veteran status age national origin ancestry citizenship physical or mental disability medical condition genetic information or characteristics (or those of a family member) pregnancy or other status protected by applicable law.

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