Long Term Care - Florida Medicaid RVP

Profile

Job Information

Humana

Long Term Care - Florida Medicaid RVP

in

Tampa

Florida

Description

Through product and service offerings anchored in a whole-person view of human well-being, Humana embraces a focus on stimulating positive individual and population changes while nurturing a sense of security, enabling people to live life fully and be their most productive. Humana Healthy Horizons in Florida Regional Vice President of Long Term Care directs the strategic development, growth and operations of the Florida Long Term Care plan. This role has overall accountability to meet revenue, membership and operating income objectives, develop key provider affiliations, establish an influential relationship with the state of Florida, direct and effectively develop strategic goals into specific business plans, and create a successful, collaborative team of people to achieve these goals.

Responsibilities

Humana Healthy Horizons in Florida Regional Vice President of Long Term Care directs the strategic development, growth and operations of the Florida Long Term Care plan. This role has overall accountability to meet revenue, membership and operating income objectives, develop key provider affiliations, establish an influential relationship with the state of Florida, direct and effectively develop strategic goals into specific business plans, and create a successful, collaborative team of people to achieve these goals.

This role manages all aspects of profit-and-loss, driving overall performance, leading strategic planning and managing a state team-based operation. Working closely with the Humana Healthy Horizons leadership team the RVP will become familiar with the established vision, mission and strategies of the organization and will build on these to effectively define, articulate and address the current and future needs and priorities of the local market. They will effectively lead a team that is focused on making a difference for our members and our state partners.

This role is expected to lead cross functional teams to deliver on revenue, membership, quality scores and outcomes, operating income objectives, develop key provider relationships, establish an influential relationship with the state, direct and effectively develop strategic goals into specific business plans, and create a successful, collaborative team of people to achieve these goals.

The role will also need to collaborate closely with the Medicaid health plans in the market to meet state and federal policy objectives and requirements.

Primary Responsibilities:

Financial Acumen and Management

Demonstrated experience managing administrative expense, unit cost management and utilization management with respect to clinical and/or LTC care delivery services.

Sound financial management and achievement of annual budgetary objectives, including development and execution of trend management initiatives.

Profit & Loss accountability for approximately 30,000 Long Term Care members

Understanding of trends and mitigation; ability to execute on profitability strategies

Customer Relationship Management

Collaborates with the state partners to build long-lasting transparent and trusting relationships

Manage day-to-day business inquiries and ongoing relationship management support for AHCA with regard to Long Term Care program services.

Provide external leadership and collaboration with LTC network associations, local areas on aging, lead agencies and community based organization partnerships

Demonstration of compassion & passion for vulnerable populations

Build, develop, improve, influence and expand relationships with key government sector customer groups, providers/provider networks and government/regulatory stakeholders within the market.Drive strong brand recognition and reputation within the market and community to positioning health plan for procurements and re-procurements

Strategy and Growth

Direct the strategic development, growth and operations of the health plan in providing innovative care by developing and executing market-specific strategies to drive sustainable and profitable growth.Effectively develops strategic goals and turns those goals into specific operating and business plans that are executed in partnership with intersegments

Ensure commitment/support for health plan strategies and programs from internal and external stakeholders.

Lead the strategic direction and decision-making for RFP bid processes as required, in order to drive business growth.

Lead the government sector in industry reform and business growth.

Identify and/or pursue potential business opportunities with new and/or existing

Develop network contracting strategies, including the composition of the network and use of VBC arrangements

Identify market-specific and/or regional priorities and determine the appropriate strategic approaches that will drive business growth and differentiate in the marketplace

Deliver value to members by optimizing the member experience and maximizing member growth and retention

Operational Compliance & Business Process Oversight

Day to day oversight and accountability for the overall performance and operational success of the LTC product

Develop strategies and objectives for long term care consistent with the mission and philosophy of Humana

Display a commitment to quality and innovation

Leadership and Associate Engagement

Lead and influence functional partners by fostering collaborative partnerships

Influence and negotiate effectively to arrive at win-win solutions

Communicate and present effectively, listen actively and attentively to others, and convey genuine interest

Ability to lead by example and hold employees accountable to complete the tasks they are assigned and to perform the duties of their jobs

Lead change and innovation by demonstrating emotional resilience, managing change by proactively communicating the case for change and promoting a culture that thrives on change

Effectively represent the market in national and regional discussions/processes within Humana, including business planning and regular leadership meetings

Demonstrated servant leadership skills and experience managing large business teams of 100 FTE roll-up.Personal accountability and commitment to continuously improve the associate experience

Qualifications and/or Relevant Experience

Bachelor's Degree

A minimum of 7 years of experience working directly with Medicaid and Medicare programs

5 years of experience in a senior leadership or product line management capacity

5 years of experience leading and managing people

5 years of experience working in a matrix organization

Experience in strategic planning and development

Experience with Long Term Care

Demonstrated successful leadership skills in program execution and people management

Proven leadership skills in both internal and external environments

Ability to execute to short- and long-term growth and profitability targets

Previous experience with the provider and payor side

Associate will need to reside in Florida, preferably Tampa

25% travel within the state of FL

Preferred Qualification

Master of Business Administration. Health Administration or Public Health

Service delivery and/or care management experience in a Long-Term Care setting (Nursing Facility, Long Term Acute Rehabilitation, Assisted Living Facility)

Medicaid Health Plan Long Term Care product experience

Additional Information

For this job, associates are required to be fully COVID vaccinated (preferred) or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.

If progressed to offer, you will be required to:

Provide proof of full vaccination or commit to testing protocols

*OR  *

Provide proof of applicable exemption including any required supporting documentation

​​Medical, religious, state and remote-only work exemptions are available.

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com