This job was posted by https://idahoworks.gov : For more information, please see: https://idahoworks.gov/jobs/2258989 Looking for a way to make an impact and help people?

Join PacificSource and help our members access quality, affordable care!

PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.

Diversity and Inclusion: PacificSource values the diversity of the people we hire and serve. We are committed to creating a diverse environment and fostering a workplace in which individual differences are appreciated, respected and responded to in ways that fully develop and utilize each person\'s talents and strengths.

The Vice President of Medicare and Individual is a member of PacificSource\'s Executive Management Group charged with building, overseeing, and driving the success of our Medicare and Individual lines of business. This role is responsible for building and executing a profitable growth strategy for both lines of business. The Vice President of Medicare and Individual will be the subject matter expert, champion, and senior leader with direct responsibility for Medicare Advantage, Dual Special Needs Plan (DSNP), and Individual segments (on and off exchange) and corresponding accountability for profit and loss (P&L), strategic planning, and execution against strategies. This position develops strategic plans and annual work plans for each line of business consistent with PacificSource\'s enterprise strategy and is responsible for gaining senior leadership agreement for investments, allocations, and initiatives that deliver on the strategic plan. This role also manages a leadership team to deliver on the strategic plan and works collaboratively with other leaders. This work includes leading internal teams (both direct and shared services) and external partners in aligning strategic planning efforts, resource allocation, and management objectives to ensure success.

Essential Responsibilities:

Manage the P&L for the line of business.

Develop and execute a strategic plan and annual work plan for the Medicare and Individual lines of business.

Provide strategic leadership for lines of business across the organization.

Develop and lead a governance model that ensures alignment and execution of the work necessary for both lines of business working across intersecting departments, matrixed relationships, and external parties.

Ensure both lines of business meet all Centers for Medicare and Medicaid Services (CMS) and state regulatory and contractual requirements.

Maintain an enterprise view of PacificSource while establishing Medicare and Individual priorities, consistent with a deep understanding of the attributes required for success in government-regulated and publicly subsidized health care programs.

Build and maintain relationships with PacificSource\'s Medicare and Individual provider partners, brokers, regulators, and other internal and external stakeholders, including the Medicaid and Employer Group lines of business. Align strategies and tactics to achieve a competitive position, profitable lines of business, superior market share, and sustained competitive advantage.

Ensure that critical initiatives and projects are adequately planned, resourced, and executed.

Develop strategic business partnerships with internal departments and leaders to ensure strong operating performance, high levels of member satisfaction and quality performance, access, compliance and audit readiness, and sound financial performance. Develop and monitor departmental and lines of business budgets.

Maintain optimal alignment and visibility for Medicare and Individual init atives at all levels of the company through presentations, maintenance of monitoring dashboards, and integration with departmental and individual performance objectives, and deploy efforts to consistently, transparently, and effectively relay strategic messages to the management team and staff.

Supervise departments and employees, and manage, coach, motivate, and guide employees.

Conduct market research, competitive analysis, and financial assessments to evaluate improvement opportunities and business strategies in concert with PacificSource\'s vision, values, and enterprise strategy.

Support the organization\'s commitment to diversity, equity, inclusion, and belonging by fostering a culture of dignity, cultural awareness, compassion, and respect.

Work closely with the Compliance Department and others to ensure policies, procedures, workflows, lifecycle strategies, product offerings, and success initiatives comply with state and federal regulations.

Closely monitor policy, legislative and competitive developments, and Medicaid priorities that impact the lines of business. Translate these impacts to the organization and lead communication, planning, and implementation efforts required for the organization to respond.

Represent PacificSource externally in community, state, regional, an