VP-Medicaid

Presbyterian Healthcare Services

1d•Hybrid

About The Position

Presbyterian Health Plan (PHP) seeks a visionary and strategic executive to serve as its VP, Medicaid. This is a pivotal leadership role designed for an individual who is passionate about serving the complex and diverse needs of Medicaid members and who possesses the sophistication to navigate the intersection of healthcare policy, state and federal regulation, and community-based care. As a national leader in Medicaid innovation, PHP is committed to designing programs that address the unique needs of New Mexicans—spanning rural, frontier, urban, and Native American sovereign communities. The VP, Medicaid will be the architect of this evolution, ensuring that the health plan remains a competitive, high-performing partner to the State of New Mexico and a tireless advocate for its most vulnerable populations. This position is open to remote applicants within the United States (excluding residents of CA, IL, ND, NY, OH, WA, and WY). For candidates residing in New Mexico and within 60 miles of a Presbyterian location, a hybrid schedule will be in effect to facilitate in-person collaboration and community engagement.

Requirements

Visionary and strategic executive
Passionate about serving the complex and diverse needs of Medicaid members
Sophistication to navigate the intersection of healthcare policy, state and federal regulation, and community-based care
Experience in developing and executing strategic plans
Ability to provide input on state strategy and foster alignment
Experience leading functional teams without direct reporting lines
Experience in government relations
Ability to conduct market surveillance of national and state market shifts
Experience providing strategic direction for quality initiatives and performance measures
Ability to champion a culture of equity, diversity, and inclusion
Experience building and leading high-performing teams
Ability to provide guidance and mentorship

Nice To Haves

Experience with Medicaid waivers and policy

Responsibilities

Develop and execute strategic plans that meet the expectations of Medicaid members, state agencies, and federal regulators.
Provide input on the State’s strategy for achieving their vision, fostering alignment with Presbyterian’s capabilities and new business models.
Lead functional teams across PHP (Network Contracting, Claims, Population Health, Pharmacy) without direct reporting lines to ensure seamless Medicaid service delivery.
Engage fully in the government relations process to influence a positive perception of PHP’s Medicaid program.
Provide ongoing surveillance of national and state market shifts, including changes in Medicaid waivers and policy, to mitigate risk and inform strategy.
Provide strategic direction for quality initiatives and performance measures while championing a culture of equity, diversity, and inclusion.
Build and lead high-performing teams, providing guidance and mentorship to foster a culture of accountability and innovation.