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VP, Duals/SNP Programs

Work At Home, USA | Cigna

  • Industry:
    Healthcare - Health & Life Insurance
  • Position Type:
    Full-Time
  • Functions:
    General Management
    Operations / Production
  • Experience:
    15-20 years
Job Description:
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Establish and set direction on where the Duals product should be offered geographically, including expansion and penetration objectives development of new business models and strategic partnerships; determination of the need for specific products and services; leadership of the strategic plan in conjunction with senior level leaders; and construction of an optimal operating model.

Own strategic responsibility for Duals product, competitively positioning the product through an understanding of the market landscape, and produce a winning product in the industry. The role will ensure financial levers and drivers are aligned to achieve optimal product results, providing customer value and affordability while meeting financial goals.

Own the end-to-end development and implementation an effective value-based market strategy to support medical cost improvement and profitable growth, integrating inputs from product development, actuary, finance and operations, CHS local markets, clinical leadership, IT, Stars, and Risk Adjustment and other matrix partners. 

Works with Medicaid and Medicare teams to ensure program requirements are met from RFP/ application through implementation.

Participates in the development and review of regulatory submissions (e. g., applications, bids) and beneficiary-facing materials specific to the DSNP product

Collect and maintain data (e. g., socioeconomic, demographic, competitive) unique to dual eligibles in the market to influence product strategy and execution

Prepare and deliver routine reports to market and corporate leadership related to DSNP product performance

Identifies gaps and recommends enhancements related to new and/or existing products, services and workflows based on broad view of the organization; works with market, corporate, and shared services area to prioritize and implement

Collaborates and partners with other functional managers, other business areas across/within segments or other business areas to ensure all workflow processes and interdependencies are identified and addressed.

Maintain appropriate relationships with Centers for Medicare and Medicaid Services (CMS) to ensure compliance with guidelines and requirements and produce products to meet those parameters. Evaluates conditions to identify and implement shifts in strategic direction as needed

Conduct financial analysis and participate in cross-development matrix teams to analyze business opportunities and address critical issues (e.g. network growth, provider termination, etc.) Also participate in the development of cross-product financial plans, business plans and strategy to support administrative, financial, and marketing objectives. 

Manage budgeting and forecasting initiatives for product lines to networks costs and provider contracts in partnership in finance. Coordinate all budget and expense management activities through effective planning, monitoring and forecasting.

Identify opportunities for innovative products and services, network configurations, service improvements and cost savings and conducts competitive intelligence research.

Ensure successful handover to service operations and network teams for network and product management post-implementation.

Develop and ensure consistency with product and profitability on the future of the product. Provide leadership and a roadmap for others. 

Facilitate and ensure regular, ongoing, and effective communications among pharmacy leaders, matrix partners, key contacts across the segment and enterprise as appropriate

Drive a “lean startup” style environment of constant experimentation and quick decision-making in alignment to strategy and organizational values. 

Shape the culture of the organization as it adjusts to an ever changing marketplace. Promote an organization that strategically builds the business and client relationships, has a long-term vision in the market, and rewards/ encourages accountability while recognizing individuality and diversity.

Initially an individual contributor, highly-matrixed role. Must work by influence/building relationships with others. May directly manage others.

~ 25-30% of travel


Qualifications


Bachelor’s degree highly preferred

A minimum of 15 years health care experience

At least 10 years strong leadership and management experience in a complex organization that is positioned for growth and expansion

Strong Medicare/Medicaid health plan experience, specifically Duals, DSNP & MMP knowledge 

A proven track record of building, motivating and driving results

Strong financial acumen skills

5+ years progressively responsible leadership experience 

Strong cross-functional and indirect leader, proven ability to quickly build relationships internally and externally

Execution focus, Strong communication & information sharing skills (oral and written), Strong financial acumen required 

Superior knowledge/experience in the Medicare industry required. Extensive knowledge of the health care marketplace, financial analysis, current reimbursement issues, budgets, and operational analysis required.


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