CEO MEDICARE ADVANTAGE HEALTH PLAN – EAST COAST
Unique opportunity for talented Medicare Advantage Executive to lead a start-up MA Plan. Ideally, the CEO will be based in OH, MD or IN but, for the right candidate, the possibility of working remotely from the East Coast may be an option.
The French Group is retained to assist in identifying a CEO for our client, a provider-sponsored MA Plan. The CEO will be responsible for the design, development and implementation of a growth strategy for the overall operations of the Company. The successful candidate will have significant experience leading product development and sales/marketing for SNP/MA products.
• Oversee key staff positions in Sales, Marketing, Compliance, CMS Bid Development and the
President of Plan Operations to achieve the company’s business plans and budgetary requirements.
• Develop and implement company growth strategies focused on the ISNP and CSNP products, including product design, pricing strategies, segmentation, CMS bid processes.
• Participate and implement development of expansion strategies, including joint ventures
• Lead the government relations strategy on behalf of the Plan and in coordination with the owners and enterprise leaders to include communication with CMS, State Medicaid departments and DOI
• Oversee CMS contract to ensure program requirements are met, including ensuring that required filings, and reporting are timely and accurate.
• Evaluate effectiveness of MA Plan operations and integration with other Company operations and assist in the development or expansion of insurance related products and services.
• Plan and organize quarterly board meetings, including agenda development
• Oversee compliance department to ensure the Company is following all CMS and State quality and regulatory standards, laws and other regulations that impact the business.
Selected Candidate Requirements:
• Degree in health administration, business administration, or another related field; MBA desirable.
• 8+ years of experience in a large, complex managed care organization or provider system with a proven ability to lead a multi-functional team that produces tangible results.
• Medicare Advantage Plan start-up and sales/marketing experience very strongly preferred
• Extensive experience dealing with CMS, DOI and other regulatory agencies required
• Experience with growth planning, government and external relations, and product development
• Proven success in developing strategic and operational platforms and leading / mentoring a high-performance product development team.
Education: Bachelor’s degree required, Master’s degree and/or Law degree preferred.
Skills/Abilities: The ideal candidate will have a proven track record of creating and managing a successful and fully integrated health care compliance program. 10+ years’ experience in managed care with Medicaid and Medicare regulatory compliance experience with a minimum of 3 years in a management position required. Knowledge of CMS rules and regulations required.
The VP Compliance is a critical business leader and contact for regulatory agencies thus requiring superior interpersonal, negotiation, influencing and presentation skills. The VP Compliance must have a successful track record for oversight and management of Medicare and Medicaid Compliance with a proven ability to lead transformation and promote accountability. The successful candidate will also have strong strategic and analytical skills as well as excellent oral and written communication, time management and organizational skills.
Tricia French RN, BSN
President & CEO
The French Group