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Job Description

The Vice President, Medicare is the strategic leader responsible for developing and executing Priority Health's Medicare strategy to achieve near-term and long-term growth and margin targets in the highly competitive Medicare market. The VP is accountable for profit and loss (P&L) and delivers results by directly leading and motivating high performing teams and by driving performance from matrixed partners.

The VP uses data-driven approaches to develop a deep understanding of the competitive landscape, market needs, and market innovations and to create a competitive and differentiated value proposition for growth. This role champions quality and experience of care, operational excellence, and compliance. As a Medicare thought leader, the VP partners with internal stakeholders to develop Priority Health's Medicare policy positions and share it with external stakeholders, including industry associations, regulatory agencies, and policy makers.

The VP is a senior leader in the organization who partners across divisions to achieve enterprise goals. Key success factors for this role include exceptional communication skills, effective collaboration, and experience leading teams and developing talent.

#LI-SH

• Leads Medicare line of business, defining and executing strategies and tactics to achieve near-term and long-term growth and margin goals in the highly competitive Medicare market. Delivers results by directly leading high performing teams (e.g., Sales, Product, Product Marketing, Product Operations, Retention, etc.) and by driving performance from supporting teams in a matrixed environment (e.g., Risk Adjustment, Medical and Care Management, Marketing, Network, Operations, Information Technology, etc.).
• Oversees product strategy and the product development cycle, including the design, execution and operational sequencing of products from concept to customer, meeting all "go-to-market" milestones as well as profitability, customer service, speed-to-market, quality, and compliance requirements. Ensures competitiveness of product offerings by developing deep understanding of competitive landscape, market needs, market innovations, and regulatory environment and applying it to Priority Health and its unique value proposition.
• Develops and executes the sales and retention strategy including strategies for omni-channel, data-driven acquisition and retention within Medicare and across lines of business (e.g., age-in from Medicaid, Individual, and Commercial lines of business).
• Champions high quality care and experience, operational excellence, and compliance, ensuring long-term viability as we grow the business. Leads capital budgeting process for Medicare, prioritizing work required for market success and making trade-offs as needed.
• Shapes health policy by working with Government Affairs and other stakeholders to provide thought leadership on Medicare for the organization and for external stakeholders, including industry associations, CMS, and legislators; supports development and communication of advocacy positions related to Medicare.
• Collaborates effectively (1) with stakeholders across the organization (including Risk Adjustment, Population Health, Actuarial, Operations, Network, Medical and Care Management, Marketing, Information Technology, etc.), (2) with the care delivery arms of the integrated Beaumont Health Spectrum Health system, and (3) with external stakeholders (including providers, agents, vendors, regulators, etc.) to achieve enterprise goals for growth and margin in a way that moves us further along on our healthcare transformation journey.
• Recruits, develops and motivates a high performing team, and provides career and skill development for the team. Motivates and inspires the team and others stakeholders in the organizational vision and strategy for Medicare.
• Communicates effectively at all levels of the organization (board, executive, management, team) and externally through a range of channels.

• Required Bachelor's Degree or equivalent
• Preferred Master's Degree MPH, MBA, or similar degree

• 10 years of relevant experience skills, knowledge, abilities typically gained through 10+ years of related experience in health care or other similarly regulated industries, with a preference for experience in leading teams, Medicare, and P&L Required

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Spectrum Health requires all team members to receive the COVID-19 vaccinations subject to certain exclusions based on the team member’s job category. Spectrum Health is committed to granting reasonable accommodations in accordance with applicable laws.

Accommodation Notice: If you are a qualified individual with a disability, you may request a reasonable accommodation in Spectrum Health's application process. Contact us at 616-486-SHHR (7447).

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