VP EXECUTIVE DIRECTOR DC HEALTH PLAN

Company: MEDSTAR HEALTH
Location: Washington
Posted on: October 19, 2024

Job Description:

General Summary of Position

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The Vice President (VP) - Executive Director is the visionary leader responsible for the long-term success and sustainable growth for MedStar Family Choice - DC's health plan. The incumbent requires a passionate advocate for health equity, coupled with strategic expertise in navigating the complexities of the Medicaid program and leading the organization through dynamic regulatory and healthcare environments. The VP - Executive Director is accountable for the day-to-day operations and profit and loss accountability of MedStar Family Choice - District of Columbia. Responsible for integration of the strategic plan of the organization. Manages the operational and financial results of the health plan and provides executive direction and leadership to management and associates. The ideal candidate will champion the needs of our members while cultivating strong partnerships with state officials, providers, and community organizations.
Primary Duties and Responsibilities

• Possess a deep understanding of the Medicaid program framework, including eligibility criteria, financing models, provider network management, and program regulations.
• Develop department goals, objectives, policies, and procedures. Ensure compliance with business unit policies and procedures and governmental and accreditation regulations.
• Oversee the financial health and sustainability of the Medicaid health plan. Manage budgets, revenue projections, resource allocation and ensure fiscal responsibility and compliance with regulations. Develop and recommend department operating budget and manage resources according to approved budget.
• Select, train, orient, and assign department staff. Develop standards of performance, evaluate performance, and conduct performance management planning. Initiate or make recommendations for personnel actions. Maintain ongoing communication with subordinates to review programs, provide feedback, discuss new developments, and exchange information.
• This position involves leading a management team of direct reports and shared services staff and managing within a matrix environment. This position is accountable for all aspects of plan operations, ensuring quality, cost-effectiveness, and a positive member experience.
• Develop and contribute to the achievement of established goals and objectives and adhere to MedStar Health, MedStar Family Choice.
• Provide assistance and input to the medical expense economics team charged with analyzing cost drivers and identifying and implementing cost improvement plans where appropriate.
• Ensure strict adherence to all federal and Maryland state Medicaid regulations, including data privacy and security measures. Proactively monitor legislative changes and adapt strategies accordingly. Provide leadership and maintain operations and procedures to ensure MedStar Family Choice -DC is in compliance with its government contracts.
• Assist in the development of annual and long-range operating and capital budgets and forecasts for MedStar Family Choice.
• In collaboration with the President of MedStar Family Choice, develop, implement, and manage a strategic planning process that results in a vision for MedStar Family Choice -DC consistent with MedStar Health's strategic plan, and defines the specific operational strategies required to accomplish those organizational goals and objectives.
• Serve as the principal point of contact and liaison between MedStar Family Choice - DC and the Department of Healthcare Finance.
• Ensure exceptional member experiences and satisfaction. Lead efforts to address member concerns, resolve issues promptly, and provide accessible support resources.
• Responsible for representing or designating representative(s) for MedStar Family Choice-DC at all meetings called by Department of Healthcare Finance and other agencies.
• Prepare and present information concerning MedStar Family Choice-DC operational performance and strategies to the MedStar Family Choice board of directors.
• Participate in meetings and on committees and represent the DC health plan in community outreach efforts.
  Minimum Qualifications
  Education

• Bachelor's degree in Business Administration, Public Health, Health Administration, or related field required.
• Master's degree preferred.
  Experience
  • 10+ years of progressively responsible experience in healthcare, delivery systems, or health plan in a senior role, ideally with a managed care organization; (successful experience with more than one organization is preferred) required.
  • Minimum of five (5) years in a senior leadership role within a Medicaid organization required.
    Knowledge, Skills, and Abilities
    • Proficient problem solving, including being able to identify and resolve complex problems, such as developing innovative solutions based on extensive knowledge of managed care.
    • A broad understanding of information systems and programs and the strategic and operational values they bring to healthcare analytics and operations. Complete understanding of the financial, operational, and regulatory processes of the Maryland/District of Columbia Medicaid managed care program.
    • Excellent verbal and written communication skills.
      This position has a hiring range of $213,800 - $289,200.
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Keywords: MEDSTAR HEALTH, Wheaton-Glenmont , VP EXECUTIVE DIRECTOR DC HEALTH PLAN, Executive , Washington, Maryland