RVP & Plan President South Carolina Medicaid Health Plan
Elevance Health

Job Info

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The Market Plan President Wellpoint South Carolina is responsible for the fiscal, operational management, legislative and regulatory objectives of an assigned Health Plan. A Health Plan at this level is large and complex in operating factors, which may include alliance or other joint venture relationships. Primary duties may include but are not limited to:

• Establishes strategies that create or sustain a competitive advantage. Aligns strategy to achieve business goals and builds a culture of accountability.
• Manages the P&L of the assigned Health Plan.
• Oversees operating gain, growth, cost of care commitments, revenue, quality, and accreditation goals.
• Develops and manages key State regulatory and legislative relationships and processes, including premium rates, covered populations, eligibility, benefit design, networks, administrative requirements, and new products.
• Collaborates with shared services support to reach Health Plan objectives. Ensures contract compliance and provides oversight of risk management programs.
• Manages customer and regulatory relationships, including state regulatory and legislative processes.
• Role will lead the health plan and be P&L owner driving overall success of the plan.
• Establish and maintain growth partner relationships on behalf of the health plan.
• Act as face of SC Wellpoint with regulators, community and network, including meetings, phone calls, etc. and establish relationships.
• Guide and lead implementation teams to ensure on track for program delivery, messaging and Gate delivery.
• Lead teams to ensure onsite presentation in line with SC Wellpoint messaging and state priorities.
• Due diligence of South Carolina Wellpoint program components, contract, State priorities, policies and procedures, network and GR environment
• Responsible for hire of South Carolina health plan state regulatory positions Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Qualifications:

• Requires a BA/BS degree in a related field.
• minimum of 12 years of related experience.
• 8 years of experience in government sponsored health insurance programs and prior leadership experience; or any combination of education and experience, which would provide an equivalent background.
• Medicaid Health Plan experience.
• Travel may be required.
• Must be located the Columbia South Carolina area.

Preferred:

• Master's degree preferred.
• Health Plan Start up experience.
• Experience with RFP's

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