Vice President, U.S. Family Health Plan

Found in: Appcast Linkedin GBL C2 - 3 weeks ago

Hanover, United States Johns Hopkins Health Plans Full time

POSITION SUMMARY:

The Vice President, U.S. Family Health Plan (USFHP) at Johns Hopkins Health Plans (JHHP) is responsible for all P&L and business functions in the Johns Hopkins U.S. Family Health Plan. This leader plays a pivotal role in overseeing and optimizing the business, meeting regulatory and reporting requirements, and leading growth of the health plan. This executive is responsible for developing and implementing strategies to enhance the quality performance, operational performance, and financial performance of the health plan, while directly managing a team of staff and collaborating effectively with shared service functional partners at JHHP.

JHHP seeks to ensure high-quality, member-centric, equitable, and affordable health care for the members and communities we serve. As a provider-sponsored health plan, JHHP is uniquely positioned to improve provider collaboration and managed care effectiveness to support these objectives, including through innovative value-based arrangements. The VP, USFHP plays a critical role in driving these efforts, backed by the clinical expertise and national reputation of Johns Hopkins Medicine.

The VP, USFHP collaborates with medical professionals, operational groups at JHHP, Johns Hopkins Medicine staff, external provider partners, and other stakeholders to ensure that the health plan excels in clinical and operational performance while aligning with industry standards and meeting regulatory requirements. The VP, USFHP leads initiatives to improve patient outcomes, control costs, and enhance the overall health and well-being of plan members. The VP, USFHP also develops growth strategy, contributes to USFHP policy development, and fosters relationships with healthcare providers, Defense Health Agency (DHA) staff, and other stakeholders to establish a comprehensive and effective health plan offering.

REPORTING RELATIONSHIP

The VP, USFHP reports directly to the President & CEO of Johns Hopkins Health Plans. The VP, USFHP supervises approximately 7 staff and collaborates with a variety of cross-functional staff across the JHHP organization. Johns Hopkins Health Plans is governed by a Board of Directors, comprised of both Johns Hopkins Medicine Directors and independent external Directors.

KEY RESPONSIBILITIES:

The following describes some specific responsibilities:

  1. Responsible for the performance of USFHP P&L
  2. Responsible for operational performance and regulatory compliance of USFHP, in accordance with Department of Defense (DoD) and other applicable requirements
  3. Develops annual budget for USFHP. Ensures targets are met and develops remediation plans when required to ensure goal attainment
  4. Develops annual membership growth targets and strategy for USFHP. Closely collaborates with Sales & Marketing to drive growth for the business, including increased market penetration and geographic expansion
  5. Responsible for developing plans and successful execution of quality, operational, and financial objectives for USFHP
  6. Orchestrates annual USFHP rate setting and negotiation with DHS, ensuring accuracy and compliance with rate requirements
  7. Collaborates with key provider groups to ensure performance targets are met, including Johns Hopkins Community Physicians, JHM, and other key health systems
  8. Provides guidance on DoD policy and funding matters to numerous internal stakeholders, including JHHP leadership and JHM stakeholders
  9. Collaborates with JHM leadership to distinguish Johns Hopkins USFHP as the premier academically-based, integrated health care delivery system partner for DHS, based on data science-driven clinical practice.

REQUIRED EDUCATION & EXPERIENCE

  1. Bachelor’s degree in business, health care, or a related field. MBA or advanced degree preferred.
  2. Seven or more years of experience in managed care.
  3. Prior experience in a health plan with P&L accountability.
  4. Experience building processes and systems.
  5. Experience with health plan marketing and sales.
  6. Experience developing and executing growth strategies, including new market expansion
  7. Deep knowledge of managed care concepts, medical cost containment, and quality improvement practices.
  8. Tricare and military health experience preferred.
  9. Ability to obtain DoD security clearance and pass any required background checks.

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