VP, Medicaid Regional President (CEO) -WI
About The Position
Become a part of our caring community and help us put health first The Chief Executive Officer (CEO) for Wisconsin is responsible for the overall strategic direction, oversight, and administration of programs and services for our Medicaid program. This individual leads the Wisconsin Medicaid Executive Leadership team and reports directly to the SVP, Divisional Medicaid Leader. Based in Wisconsin, the CEO serves as the DHS primary contact regarding all issues and coordinates with other Key Staff to fulfill programmatic requirements. The individual in this role publicly represents Humana Medicaid (iCare and Inclusa) in Wisconsin, enhancing and further developing relationships with stakeholders throughout the state of Wisconsin. The CEO manages the development, operations, and results of the health plan and requires an in-depth understanding of how organization capabilities interrelate across segments and enterprise wide.
Requirements
- Bachelor's degree
- 7+ years of experience in Medicaid MCO plan operation highly preferred
- Experience with budgeting and financial management of a health plan
- Six to ten years' experience working in healthcare or government leadership or operations management
- Leadership background with more than five direct reports
- Must reside or be willing to relocate to Wisconsin, preferably Milwaukee
Nice To Haves
- Master's degree
- Experience in Medicare Advantage
Responsibilities
- Manages the Wisconsin Medicaid health plan Executive Leadership team, through which all plan associates report
- Accountable for profit and loss of Family Care, Family Care Partnership, and Badger Care/SSI
- Manages Quality withhold and STARS results of the health plan
- Drives principles and culture pivots to simpler, faster and better care
- Develop strategies, formulate policies, and oversee operations to ensure objectives and goals are met
- Represents Humana to the public, Enrollees, associates, DHS, and subcontractors
- Develops clear and measurable plan objectives, goals, and ideas
- Confirms health plan compliance with federal and state laws and programmatic requirements, including fraud, waste, and abuse; makes decisions in an ethical manner
- Oversees operational policies and procedures
- Ensures long-term health plan financial success, sustainability, and growth
- Develops and adheres to budgets
- Resolves urgent and emergency matters according to applicable policies and procedures
- Demonstrated experience managing administrative expenses, unit cost management and utilization management with respect to clinical and/or LTC care delivery services.
- Lead the strategic direction and decision-making for RFP bid processes as required, to drive business growth.
- Works with Humana National Medicaid support teams to infuse best practices from other states and drives new ideas and initiatives from across the Medicaid and healthcare industry
- Supports the growth of associates to enhance health plan leadership and career development
- 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
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What This Job Offers
Job Type
Full-time
Career Level
Executive
