VP Medicare Advantage-Johns Hopkins Health Plan

JHHP SUMMARY:

Johns Hopkins Health Plans (JHHP) is the managed care and health services business of JohnsHopkins Medicine. JHHP is a $3.2B business serving nearly 500000 members with lines ofbusiness in Medicaid Medicare commercial military health health solutions and venture investments. JHHP is a leader in provider-sponsored health plansbacked by the clinical expertise of Johns Hopkins Medicineand is poised for future growth.

Many organizations talk about transforming the future of healthcare at Johns Hopkins HealthPlans we are setting the pace for change within the healthcare industry. We develop

innovative analytics-driven health programs in collaboration with provider partners to driveimproved quality and better health outcomes for our members and the communities we serve.

If you are interested in improving how healthcare is delivered and have a passion to be at theforefront of change JHHP is the place to call home

Position Summary

The Vice President Medicare Advantage is a senior executive responsible for leading and growing Johns Hopkins Health Plans Medicare Advantage (MA) and Dual Eligible Special Needs Plan (D-SNP) business across two states. This leader owns full P&L accountability and is responsible for driving strategy STARs performance benefit and product design growth and margin optimization while ensuring operational excellence and compliance with CMS regulations.

This role requires a bold data-driven executive who can balance innovation with disciplined execution to grow market share improve member experience and achieve best-in-class quality and performance.

Key Responsibilities

Strategic Leadership & Growth

• Develop and execute the multi-year growth strategy for Medicare Advantage and D-SNP products across markets.
• Oversee product and benefit design annual CMS bid submission and market positioning aligned with business objectives and regulatory expectations.
• Collaborate closely with the leadership of Marketing Sales Provider Relations and Population Health to drive sustainable enrollment growth and member retention.

Operational & Financial Oversight

• Accountability for all aspects of Medicare Advantage and D-SNP operations including oversight of delegated vendors network performance clinical integration and customer experience.
• Own full P&L responsibility for the MA & D-SNP portfolio; track and report performance regularly to the CEO and Board.
• Ensure alignment with revenue cost MLR administrative ratio and margin goals.

Quality & STARs Excellence

• Ensure effective year-round STARs strategy and execution in collaboration with clinical pharmacy operations and analytics teams.
• Ensure improvement initiatives for HEDIS CAHPS HOS and operational measures to achieve 4 STARs ratings.

Regulatory Compliance & Vendor Oversight

• Ensure full CMS compliance and timely submission of required deliverables.
• Serve as key contact for CMS and state regulators in conjunction with Compliance and Legal.
• Oversee the performance and accountability of delegated vendors ensuring SLAs contracts and deliverables are met or exceeded.

Team Leadership

• Inspire and lead a high-performing cross-functional team across Medicare operations strategy sales and clinical integration.
• Foster a culture of collaboration accountability innovation and continuous improvement.

Qualifications

• Minimum of a bachelors degree in business administration health care administration or a related field. Masters degree or MBA highly preferred.
• Minimum of 10 years of progressive leadership experience in Medicare Advantage with 5 years in executive-level roles.
• Demonstrated success in managing a multi-state Medicare Advantage and D-SNP portfolio with P&L responsibility.
• Deep understanding of CMS regulations STARs bid/benefit design and the D-SNP model of care.
• Proven ability to lead across matrixed organizations build consensus and drive execution in complex environments.
• Strong financial operational and analytical acumen with a track record of business growth and performance improvement.

Preferred Qualifications

• Experience leading STARs improvement initiatives resulting in 4 STAR performance.
• Familiarity with delegated models and value-based care arrangements.
• Experience working with diverse and vulnerable populations.
• Understanding of Maryland market and regulated provider reimbursement.
• Experience with provider-sponsored health plans.
• Experience with Board governance and orchestrating planning and activities across internal and external Board members.

Salary Range: Minimum $0.00/hour - Maximum$0.00/ will be commensurate with equity and experience for roles of similar scope and responsibility.

In cases where the range is displayed as a $0 amount salary discussions will occur during candidate screening calls before any subsequent compensation discussion is held between the candidate and any hiring authority.

JHM prioritizes the health and well-being of every employee. Come be healthy at Hopkins!

Diversity and Inclusion are Johns Hopkins Medicine Core Values. We are committed to creating a welcoming and inclusive environment where we embrace and celebrate our differences where all employees feel valued contribute to our mission of serving the community and engage in equitable healthcare delivery and workforce practices.

Johns HopkinsHealth Systemand its affiliatesare an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity and expression age national origin mental or physical disability genetic information veteran status or any other status protected by federal state or local law.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.