Market President Regional Health Plan - Utah

Intermountain Health

10d • $67 - $104

About The Position

The Market President is the senior officer for a regional health plan and is authorized to commit the organization’s resources to develop strategy to drive integrated growth across and among product lines, ensure operational excellence, and build and maintain the organization’s brand and position in the health care market and broader business community within the defined geographic market. This role is charged with ensuring the health plan’s financial success, regulatory compliance, and delivery of high-quality healthcare services to members, employers, providers, and community partners and taking accountability for all aspects of the health plan’s successes and challenges at the local, and state l level. As the State Level Executive, this role must also effectively translate the regional health plan’s needs within the parent organization to ensure that the state and requirements – operational, regulatory, financial and otherwise are understood and executed among the needs of the other State health plans served by the centralized functions. Essential Functions Strategic Leadership: Develop, execute and integrate comprehensive market strategies that align with organizational objectives, respond to market dynamics, and advance Select Health’s mission. Lead market analysis, competitive positioning, and long-term growth initiatives for multiple products across states, territories and markets. Develop and maintain strong relationships with strategic leaders including but not limited to Insurance Commissioners, Health Cabinet Leaders, Elected Officials, Industry Associations and other key stakeholders. Business Development: Identify and oversee initiatives to increase market share, expand membership, and cultivate new business opportunities that align and enhance organizational objectives. Build and maintain strong relationships with brokers, employers, and other business stakeholders. Ensure the organization’s brand and reputation is aligned with our mission and all employees, within the region and working on the region represent that mission in all facets of their work. Branding and Marketing: Developing and managing the plan’s regional brand identity and ensuring all marketing plans are adherent. Overseeing the development and implementation of marketing strategies to promote the health plan’s services and promote plan growth and brand recognition. Development and management of any brand collaboration relationships. Overseeing and managing the member engagement journey to enhance satisfaction and retention. Operational Oversight: Ensure the delivery of efficient, high-quality services through robust management of local and centralized operations, including but not limited to customer service, claims processing, credentialing, contract loading, provider relations, and network management. Monitor performance through ongoing operational reporting, service level agreements, and auditing. Partner with local and central functions on continuous process improvements and operational performance enhancements. Financial Stewardship: Develop and manage, state, market and product level budgeting, forecasting, and financial performance. Monitor key performance indicators and ensure the market meets or exceeds financial targets. Develop and oversee risk management and cost containment programs at the state and regional levels. These can include clinical care management programs, proactive care programs, utilization management programs or others designed to ensure the delivery of high-quality care delivered in a fiscally responsible manner. Regulatory Compliance: Maintain adherence to all federal, state, and local regulations relevant to health plan operations, including licensure, reporting, and privacy requirements. Serve as a primary contact for regulatory agencies and ensure timely resolution of compliance issues. Maintain regular monitoring of statutory and regulatory making bodies to stay abreast of proposed changes and engage lobbying and/or other involvement as appropriate. Provider Network Development: Build and sustain high-performing provider networks that deliver strong clinical outcomes, provide competitive products, and deliver provider satisfaction. Oversee negotiations and contracts with hospitals, medical groups, and ancillary providers. Foster collaborative relationships with clinical leaders and operational partners and ensure the ongoing maintenance of the network through the delivery of high-quality provider education, customer service and support, innovative payment models, and quality programming. Community Engagement: Serve as the local face of the health plan, representing the organization at community events, industry forums, and stakeholder meetings. Champion initiatives that address community health needs, health equity, and social determinants of health as they align with the organization’s strategic initiatives and brand identity. Develop and oversee the region’s marketing and community engagement strategy to further the positioning of the company in its current and future markets. Team Leadership and Talent Development: Lead, mentor, and develop high performing, cross-functional teams. Foster a culture of accountability, innovation, and continuous improvement. Ensure robust talent management and succession planning practices for teams located within the region as well as centralized members working within the matrix environment. Responsible for ensuring the overall organization understands the unique needs of the region and remains aware of any significant changes to the region’s regulatory or structural requirements. Quality, Member and Provider Experience, and Clinical Outcomes: Develop and oversee programs designed to enhance member and provider satisfaction, clinical quality, and population health outcomes. Collaborate with medical directors, care management teams, and quality improvement specialists to collect, analyze and report actionable data to drive improved outcomes across products and programs such as STARS and HEDIS as well as other statewide and regional metrics. External Relations: Cultivate partnerships with local government, public health agencies, advocacy organizations, and other key influencers. Advocate for the health plan’s interests and contribute to industry thought leadership. Develop and manage the region’s government relations strategy, including but not limited to, contracting with lobbyists, participating with trade associations or other industry groups, and testifying or joining coalitions. Joint Venture: In regions where arrangements such as Joint Ventures or other unique contractual agreements are in place, the Market President is responsible for managing and executing all additional aspects of the Joint Venture contract, including but not limited to management of the executive committee, any subcommittees, any additional contractual requirements such as shared decision making, shared financial oversight, integration of additional partners, etc.

Requirements

• Bachelor’s degree and advanced degree in business administration, health management, public health, or related field is preferred; however, equivalent experience demonstrating the required knowledge, skills and abilities will be considered in place of formal education.
• Minimum of 15 years progressive leadership experience in health plan, managed care, hospital, or broader healthcare industry.
• Must have held at least one VP, C-suite or leadership level position that required P&L accountability and senior level relationship management.
• Demonstrated success in market management, operational excellence, and business development.
• Minimum of 5 years of direct supervisory experience in a matrix organization.
• Deep understanding of health plan administration, insurance regulations, and healthcare delivery systems.
• Proven leadership capabilities in strategic planning, financial management, project management, and team development.
• Exceptional interpersonal, communication, and negotiation skills.
• Excellent written and verbal communication skills.
• Ability to build strong local networks and represent the health plan in diverse public forums.
• Commitment to upholding the highest standards of compliance, ethics, and corporate responsibility.
• Market Agility
• Innovative Mindset
• Relationship Building
• Results Oriented
• Community Focused
• Health Plan Administration
• Insurance Regulations
• Healthcare Delivery Systems
• Strategic Planning
• Financial Management

Nice To Haves

• Certifications: Professional certifications in healthcare management or insurance (e.g., FACHE, CHIE, CEBS) are advantageous but not required.

Responsibilities

• Develop, execute and integrate comprehensive market strategies that align with organizational objectives, respond to market dynamics, and advance Select Health’s mission.
• Lead market analysis, competitive positioning, and long-term growth initiatives for multiple products across states, territories and markets.
• Develop and maintain strong relationships with strategic leaders including but not limited to Insurance Commissioners, Health Cabinet Leaders, Elected Officials, Industry Associations and other key stakeholders.
• Identify and oversee initiatives to increase market share, expand membership, and cultivate new business opportunities that align and enhance organizational objectives.
• Build and maintain strong relationships with brokers, employers, and other business stakeholders.
• Ensure the organization’s brand and reputation is aligned with our mission and all employees, within the region and working on the region represent that mission in all facets of their work.
• Developing and managing the plan’s regional brand identity and ensuring all marketing plans are adherent.
• Overseeing the development and implementation of marketing strategies to promote the health plan’s services and promote plan growth and brand recognition.
• Development and management of any brand collaboration relationships.
• Overseeing and managing the member engagement journey to enhance satisfaction and retention.
• Ensure the delivery of efficient, high-quality services through robust management of local and centralized operations, including but not limited to customer service, claims processing, credentialing, contract loading, provider relations, and network management.
• Monitor performance through ongoing operational reporting, service level agreements, and auditing.
• Partner with local and central functions on continuous process improvements and operational performance enhancements.
• Develop and manage, state, market and product level budgeting, forecasting, and financial performance.
• Monitor key performance indicators and ensure the market meets or exceeds financial targets.
• Develop and oversee risk management and cost containment programs at the state and regional levels.
• Maintain adherence to all federal, state, and local regulations relevant to health plan operations, including licensure, reporting, and privacy requirements.
• Serve as a primary contact for regulatory agencies and ensure timely resolution of compliance issues.
• Maintain regular monitoring of statutory and regulatory making bodies to stay abreast of proposed changes and engage lobbying and/or other involvement as appropriate.
• Build and sustain high-performing provider networks that deliver strong clinical outcomes, provide competitive products, and deliver provider satisfaction.
• Oversee negotiations and contracts with hospitals, medical groups, and ancillary providers.
• Foster collaborative relationships with clinical leaders and operational partners and ensure the ongoing maintenance of the network through the delivery of high-quality provider education, customer service and support, innovative payment models, and quality programming.
• Serve as the local face of the health plan, representing the organization at community events, industry forums, and stakeholder meetings.
• Champion initiatives that address community health needs, health equity, and social determinants of health as they align with the organization’s strategic initiatives and brand identity.
• Develop and oversee the region’s marketing and community engagement strategy to further the positioning of the company in its current and future markets.
• Lead, mentor, and develop high performing, cross-functional teams.
• Foster a culture of accountability, innovation, and continuous improvement.
• Ensure robust talent management and succession planning practices for teams located within the region as well as centralized members working within the matrix environment.
• Responsible for ensuring the overall organization understands the unique needs of the region and remains aware of any significant changes to the region’s regulatory or structural requirements.
• Develop and oversee programs designed to enhance member and provider satisfaction, clinical quality, and population health outcomes.
• Collaborate with medical directors, care management teams, and quality improvement specialists to collect, analyze and report actionable data to drive improved outcomes across products and programs such as STARS and HEDIS as well as other statewide and regional metrics.
• Cultivate partnerships with local government, public health agencies, advocacy organizations, and other key influencers.
• Advocate for the health plan’s interests and contribute to industry thought leadership.
• Develop and manage the region’s government relations strategy, including but not limited to, contracting with lobbyists, participating with trade associations or other industry groups, and testifying or joining coalitions.
• In regions where arrangements such as Joint Ventures or other unique contractual agreements are in place, the Market President is responsible for managing and executing all additional aspects of the Joint Venture contract, including but not limited to management of the executive committee, any subcommittees, any additional contractual requirements such as shared decision making, shared financial oversight, integration of additional partners, etc.

Benefits

• We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
• Learn more about our comprehensive benefits package here.
• Intermountain Health’s PEAK program supports caregivers in the pursuit of their education goals and career aspirations by providing up-front tuition coverage paid directly to the academic institution. The program offers 100+ learning options to choose from, including undergraduate studies, high school diplomas, and professional skills and certificates. Caregivers are eligible to participate in PEAK on day 1 of employment.

What This Job Offers

• Job Type: Full-time
• Career Level: Executive