RVP Medicare Market President (West)

Anticipated End Date:

Position Title:

Job Description:

RVP Medicare Market President- West

Location: May be located in any Elevance Health PulsePoint office preferably in Denver CO Grand Prairie TX Las Vegas NV.

This role requires associates to be in-office at least 3days per week fostering collaboration and connectivity while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work promoting a dynamic and adaptable workplace. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment unless an accommodation is granted as required by law.

Summary

Responsible for the fiscal operational and regulatory management for both large and complex Medicare Health plans in multiple states specifically the West region including the following states: AZ CO LA NV TX and WA. The role aligns strategy to achieve business goals.

Team Scope

Role is responsible for leading 4 direct reports.

Position Responsibilities

• Manage the health plan(s) P&L to include revenue cost management/Cost of Care SG&A and forward-looking product growth opportunities for Medicare Advantage and Medicare Supplement products

• Collaborate with growth partners in the execution of service deliverables manage the resolution of escalated issues and ensure that growth partners are following through on performance metrics.

• In collaboration with Product Actuary and Finance lead the annual bid strategy process and submission and oversee the successful implementation of plan changes.

• Oversee and participate in medical management medical staffing seasonality issues detailed communications with the medical directors and nurse leaders. Collaborate with HSO and Carelon on clinical Models of Care to best grow and manage Medicare Advantage products including DSNP and CSNP as well as to drive Stars performance.

• Oversee and participate in the development of growth strategies and retention initiatives for West markets and possible white space expansion

• Oversee marketing retention experience and product growth strategies and business initiatives as well as other community-based initiatives.

• Collaborate with national growth partners to provide oversight of Stars and Risk Adjustment performance while driving local market strategies with providers and other key stakeholders.

• Drive provider collaboration and engagement in the areas of service and Payment Innovation with deep partnership with Health Care Networks (HCN). Oversee value-based provider performance.

• Develop and implement network strategies specific to local markets identifying and cultivating strategic alliances network adequacy and network development for service area expansion building new network models with significant provider organizations and providing local strategic insight into the design and implementation of high-performance networks including facility and provider performance incentives.

• Work with growth partners to implement whole health and health equity strategies and programs to improve member health.

• Ensure Compliance and performance management in collaboration with the Compliance team growth partners and the health plan relative to CMS rules and expectations. Work with growth partners to reduce compliance actions and points.

• Oversee state SMAC (DSNP) contract requirements for regulatory reporting encounter reporting quality audits HEDIS/EPSDT state relationships for DSNP and other contract requirements. Ensure county footprint/expansion is in alignment with Medicaid growth goals and LTSS strategies.

• Oversee Alliance contract requirements and performance growth strategies and long-term strategies to maintain or grow contract for new products.

• Nurture alliance and other external partnership relationships

• Collaborate with peer Commercial and Medicaid Presidents in your health plans/markets on key growth provider community and catchers mitt strategies.

• Support internal Business Operating Review leadership presentations.

• Hire train coach counsel and evaluate performance of direct reports and lead with our Culture principles and behaviors.

Position Requirements

Requires a BA/BS degree in a related field and a minimum of 12 years of related experience including 8 years of experience in government sponsored health insurance programs and prior leadership experience; or any combination of education and experience which would provide an equivalent background. Travel may be required.

Preferred Skills Capabilities and Experiences

• Previous experience in managing P&Ls in large complex matrixed organizations.

• Previous experience developing and/or submitting Medicare Advantage bids.

• Previous experience managing value-based provider relationships

• Previous Medicaid and/or Dual Eligible experience is preferred.

• Experience/expertise in managing cost of care and trend is desired.

• Prior experience and/or expertise in driving Star performance is desired.

• Masters degree preferred.

For candidates working in person or virtually in the below location(s) the salary* range for this specific position is $215796 - 339108.

Locations: Colorado Nevada

In addition to your salary Elevance Health offers benefits such as a comprehensive benefits package incentive and recognition programs equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender race or any other category protected by federal state and local pay equity laws.

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location work experience education and/or skill level. Even within the range the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned vested and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus commission benefits or any other form of compensation and benefits that are allocable to a particular employee remains in the Companys sole discretion unless and until paid and may be modified at the Companys sole discretion consistent with the law.

Job Level:

Workshift:

Job Family:

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes including those submitted to hiring managers are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy power our business outcomes and drive our shared success - for our consumers our associates our communities and our business.

We offer a range of market-competitive total rewards that include merit increases paid holidays Paid Time Off and incentive bonus programs (unless covered by a collective bargaining agreement) medical dental vision short and long term disability benefits 401(k) match stock purchase plan life insurance wellness programs and financial education resources to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager associates are required to work at an Elevance Health location at least once per week and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age citizenship status color creed disability ethnicity genetic information gender (including gender identity and gender expression) marital status national origin race religion sex sexual orientation veteran status or any other status or condition protected by applicable federal state or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal state and local laws including but not limited to the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.