Vice President, Medicare Line of Business

4 days ago

Portland, United States Avalon Executive Search, LLC Full time

Vice President, Medicare Line of Business


Summary:

The Vice President, Medicare Line of Business, is responsible for the strategy, leadership, and success of Medicare and Individual health plans, including Medicare Advantage, Dual Special Needs Plans (DSNP), and Individual segments. This role manages profit and loss (P&L), strategic planning, compliance, and execution across these lines of business, ensuring profitable growth, competitive positioning, and regulatory adherence.


Key Responsibilities:

  • Strategic Leadership: Develop and execute strategies for Medicare and Individual plans aligned with organizational goals. Lead governance models to ensure alignment and performance across internal and external teams.
  • P&L Management: Oversee financial performance, resource allocation, and operational initiatives for both lines of business.
  • Regulatory Compliance: Ensure compliance with CMS and state regulations. Stay informed on policy and legislative changes, adapting strategies as needed.
  • Stakeholder Engagement: Build relationships with providers, brokers, regulators, and internal teams to achieve market share, profitability, and member satisfaction.
  • Performance Oversight: Lead initiatives to improve operating performance, member satisfaction, and quality outcomes. Monitor progress through dashboards and align objectives across teams.
  • Team Leadership: Manage and develop staff, fostering a culture of collaboration, accountability, and continuous improvement.


Qualifications:

  • Proven leadership in Medicare and Individual health plan management.
  • Expertise in strategic planning, P&L management, compliance, and stakeholder relations.
  • Strong knowledge of CMS regulations, market trends, and competitive strategies.
  • Demonstrated ability to lead diverse teams and drive enterprise-wide initiatives.
  • Commitment to fostering diversity, equity, and inclusion in the workplace.

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