SENIOR VICE PRESIDENT, HEALTH PLAN GROWTH & STRATEGY-ONSITE

About the role

BLEHEALTH is seeking an accomplished Senior Vice President of Health Plan Growth & Strategy to lead the organization's health plan growth, payer contracting strategy, strategic partnerships, market expansion, and long-term business development initiatives. This executive will be responsible for expanding BLEHEALTH's relationships with Medicaid managed care organizations, Medicare Advantage organizations, health systems, provider organizations, government agencies, and other healthcare partners. The SVP will initially focus on maximizing BLEHEALTH's presence throughout California while developing and executing a disciplined strategy for expansion into additional states, and countries. The ideal candidate will have significant experience within a Medicaid managed care organization, Medicare Advantage plan, population health organization, or comparable healthcare organization and will understand how health plans evaluate, contract with, implement, and monitor external provider and service organizations. This is a growth and revenue leadership position. Success will be measured by new contracts, expansion of existing contracts, new markets entered, strategic partnerships developed, and revenue generated.

Responsibilities

• Develop and execute BLEHEALTH's comprehensive health plan growth strategy.
• Identify and pursue new contracting opportunities with: Medi-Cal managed care plans, Medicaid managed care organizations nationally, Medicare Advantage organizations, Health systems, Physician organizations, Accountable care organizations, Government healthcare programs, Other healthcare organizations.
• Build relationships with senior executives and decision-makers within targeted organizations.
• Establish BLEHEALTH as a preferred partner for population health, care management, community-based services, and high-risk member engagement.
• Develop executive-level relationships with: Health plan CEOs, Chief Medical Officers, Chief Operating Officers, Medicaid Presidents, Network executives, Population health executives, Care management executives, Community health executives, Provider network leadership, Contracting executives.
• Represent BLEHEALTH at executive meetings, conferences, industry events, and strategic partnership discussions.
• Maintain ongoing relationships rather than limiting contact to contract negotiations.
• Develop a formal healthcare business-development pipeline. Identify opportunities before formal RFPs are released whenever possible.
• Maintain accurate pipeline forecasting and provide regular reports to the CEO.
• Lead the business strategy surrounding health plan contract negotiations. Work collaboratively with legal counsel, finance, compliance, operations, and clinical leadership.
• Evaluate: Reimbursement, Payment models, Performance requirements, Service expectations, Quality requirements, Geographic scope, Member volume, Reporting requirements, Financial risk, Value-based payment opportunities.
• The SVP is not expected to replace legal counsel but should understand healthcare contracting sufficiently to lead commercial negotiations.

Requirements

• Bachelor's degree required.
• Advanced degree in healthcare administration, business, public health, or related discipline preferred.
• Approximately 10+ years of progressive healthcare leadership, managed-care, payer, population-health, business-development, or contracting experience.
• Demonstrated experience working with Medicaid managed care organizations.
• Strong understanding of healthcare payer-provider relationships.
• Experience developing or negotiating healthcare contracts.
• Demonstrated record of generating new healthcare business.
• Strong executive communication and presentation skills.
• Ability to communicate effectively with health-plan executives.
• Experience developing strategic partnerships.
• Strong understanding of