Evolent Health Market President, Medicaid in Pensacola, Florida

It’s Time For A Change…Your Future Evolves Here

Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving force that brings us to work each day. We believe in embracing new ideas, challenging ourselves and failing forward. We respect and celebrate individual talents and team wins. We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans.

Are we growing? Absolutely—Are we recognized? Definitely. We have been named one of “Becker’s 150 Great Places to Work in Healthcare” in 2016 and 2017, and one of the “50 Great Places to Work” in 2017 by Washingtonian, and our CEO was number one on Glassdoor’s 2015 Highest-Rated CEOs for Small and Medium Companies. If you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a mission. Join a mission with a company behind it.

What You’ll Be Doing:

We are seeking several full-time Market Presidents located in various cities throughout the Southeastern U.S. The Market President has full P&L accountability and executing the topline strategy, oversight and organizational leadership for all areas of the health plan. He or she, as the lead market operator, will administer day-to-day business activities, and is accountable for health plan performance, including growth, quality, compliance, culture, and financial results. The candidate will have overall oversight of health plan end-to-end success, including ensuring positive member and provider experiences. Key areas of focus may include ensuring effective community stakeholder engagement, coordinated care activities, clinical programs, regulatory compliance and state relationships, rate negotiations, provider relations and contracting.

Responsibilities:

Mission, Vison, Values, Oversight and Objectives

  • Understand and apply Mission and Values to daily work. Communicate strategy and vision, performance expectations. Lead teams to obtain organizational results and work in partnership with others to achieve business objectives.

  • Set objectives based upon company strategic and operating plans, with emphasis on identifying resources requirements. Acquire, apply, and maintain knowledge of organization-wide business issues. Possess a strategic understanding of business operations and customer service.

  • Provide leadership direction and oversight as needed to achieve desired results as outlined in business plan and/or budgets for health plan.

  • Liaison with Board of Directors

  • Systematically measure performance versus plan; drive results toward expectations.

  • Identify areas for improvement in health plan and create/oversee corrective action plans as needed to achieve desired outcome.

Culture

  • Demonstrate health plan’s philosophy and values and ensure that philosophy and mission drive the day-to-day operating environment.

  • Institutionalize the vision; create the focus, ownership, and commitment to achieve it. Ensure that direct reports are engaged in activities based on organizational need and their technical skills and capabilities. Ensure internal resources and practices stimulate rather than inhibit highly effective and responsive performance.

  • Provide resources to encourage fiscally sound activities that encourage the care, education, and dignity of the underserved.

  • Support the continued growth and development of all employees to promote competence and develop/maintain skills necessary to enhance continued business growth.

  • Provide leadership direction, including agenda preparation/monitoring and facilitation as needed, for multiple meetings, work groups and health plan committees.

Provider Strategy, Engagement and Quality Outcomes

  • Dedication to providing the highest quality products and services, which meet the needs and requirements of internal and external customers.

  • Develop and provide continuing leadership for provider reimbursement strategies; oversee implementation of programs/strategies, including all sub-contractors.

  • Foster positive professional relationships between the plan and its providers.

  • Provide direction and leadership as needed to ensure achievement of NCQA accreditation status.

  • Establish procedures for monitoring and evaluating the quality and effectiveness of processes or methods.

Membership Experience, Growth and Financial Performance

  • Provide administrative review/approval of external communication vehicles as needed for member newsletters, provider newsletters, provider manuals and member handbooks, etc.

  • Monitor financial performance and the achievement of financial objectives. Ensure financial and quality performance of the organization.

Government Affairs and Regulatory Compliance

  • Provide leadership direction and oversight as needed to ensure successful outcomes for external reviews by HHS, CMS, EQRO and other regulatory bodies.

  • Maintain contacts with regulatory and legislative bodies to assure compliance with established procedures.

  • Provide strategic input to assist in successful negotiations with the state with respect to capitation rates and funding of existing or new programs/lines of business

  • Provide leadership direction and oversight as needed to ensure successful compliance with terms of State Contract/RFP.

  • Oversee preparation of all “non-financial” statutory reports required in RFP/Contract.

  • Participate in legislative activities; includes testifying and presenting to various legislative committees.

The Experience You’ll Need (Required):

  • Bachelor’s degree in Business, Healthcare or related field

  • Minimum of 14 years of progressively responsible managerial experience

  • Minimum of 7 years of senior management experience required

  • 10- 14 years of business experience including HMO, managed care, and/or Medicaid plans

Finishing Touches (Preferred):

  • Masters

  • HIPAA, NCQA, and HEDIS experience

Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin.