SVP Medicare President

Provides executive leadership for the operation of all market Medicare health plans. Provides thoughtful strategic direction for all existing programs and proactive development of progressive programs to ensure the profitability and growth of the Medicare line of business. Drives national Medicare operating model to gain efficiencies, consistency and crafts scalable, product-wide solutions that leverage best practices and advances the business. Directs profit and loss responsibility for the entire line of business. Effectively partners with executive shared services teams to ensure that enterprise-wide quality, operational, financial and leadership expectations are met. Partners with Medicaid state presidents to ensure Medicare priorities are clear and execution is occurring in line with expectations in those matrixed markets. Serve as the representative of the product line to government entities and other external agencies and ensures compliance with all relevant regulatory agencies.

Reports to: EVP, Medicare and Operations
Dept.: HPS
Location: Tampa (Henderson Road), FL

Essential Functions:

  • Provides executive profit and loss (P&L) leadership, direction and operational oversight to the Medicare health plan management teams to ensure the organization’s Medicare strategic and annual plans are translated into tactical goals and objectives that guarantee performance objectives are met or exceeded.
  • Ensures EVP, Medicare and Operations is informed and supportive of key business drivers, KPIs and market opportunities and risks. Provides recommendations to the EVP around multiyear expectations, investment priorities and strategic considerations.
  • Directs and manages the product lines financial and operational performance. Takes appropriate actions to increase revenue, leverage resources, manages and/or minimizes expenses, drive medical expense initiatives and ensure compliance with all business and administrative regulations
  • Drives consistency and optimization across the Medicare markets and enterprise via proactive collaboration with regional market leaders and Executive Directors and State Presidents.
  • Builds and drives leadership capability, model office organizational design and succession planning/talent development in each market.
  • Coaches and mentors, and drives leadership development and associate performance optimization across the product line.
  • Serves as executive liaison to the shared service areas on behalf of the individual market leaders. Works with shared services leadership to agree on line of business expectations and measures of success.
  • Leads the development of annual business plans and budgets for the Medicare line of business. Creates consistent model and set of annual goals for all Medicare markets. Supports and oversees the annual market product development cycle and makes final recommendations to the EVP, Medicare and Operations and the Medicare CFO.
  • Acts as the executive business sponsor on the Medicare expansion committee. Makes annual recommendations to the EVP,Medicare and Operations and the Medicare CFO. Oversees execution of approved expansion.
  • Parachutes into a targeted market to support unanticipated leadership changes and/or unanticipated business risk or under performance.
  • Leads line of business associate satisfaction and engagement activities, and responsible for overall associate engagement for the Medicare business
  • Performs other duties assigned.
Additional Responsibilities:
    Candidate Education:
    • Required A Bachelor's Degree in healthcare administration, business administration, finance or a related field
    • Preferred A Master's Degree in healthcare administration, business administration, finance or a related field
    Candidate Experience:
    • Required 12 years of experience in Medicare managed care P&L experience along with business management/operations, health plan finance, provider network management or managed care consulting
    • Required 7 years of management experience in a functional leader position(s)
    Candidate Skills:
    • Advanced Demonstrated leadership skills
    • Advanced Knowledge of healthcare delivery
    • Advanced Knowledge of community, state and federal laws and resources
    • Advanced Demonstrated project management skills
    • Intermediate Ability to analyze and interpret financial data in order to coordinate the preparation of financial records
    • Advanced Ability to work in a fast paced environment with changing priorities
    • Advanced Ability to drive multiple projects
    • Advanced Ability to influence internal and external constituents
    • Advanced Ability to work in a fast paced environment with changing priorities
    • Advanced Ability to lead/manage others in a matrixed environment
    • Advanced Ability to work within tight timeframes and meet strict deadlines
    • Advanced Demonstrated time management and priority setting skills
    • Advanced Demonstrated analytical skills
    • Advanced Demonstrated written communication skills
    • Advanced Demonstrated problem solving skills
    • Advanced Demonstrated negotiation skills
    • Advanced Demonstrated interpersonal/verbal communication skills
    • Advanced Demonstrated organizational skills

    Technical Skills:

    • Required Intermediate Microsoft Outlook
    • Required Intermediate Microsoft Word
    • Required Intermediate Microsoft PowerPoint
    • Required Intermediate Microsoft Excel


      About us
      Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses primarily on providing government-sponsored managed care services to families, children, seniors and individuals with complex medical needs primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, as well as individuals in the Health Insurance Marketplace. WellCare serves approximately 5.5 million members nationwide as of September 30, 2018. WellCare is a Fortune 500 company that employs nearly 12,000 associates across the country and was ranked a "World's Most Admired Company" in 2018 by Fortune magazine. For more information about WellCare, please visit the company's website at EOE: All qualified applicants shall receive consideration for employment without regard to race, color, religion, creed, age, sex, pregnancy, veteran status, marital status, sexual orientation, gender identity or expression, national origin, ancestry, disability, genetic information, childbirth or related medical condition or other legally protected basis protected by applicable federal or state law except where a bona fide occupational qualification applies. Comprehensive Health Management, Inc. is an equal opportunity employer, M/F/D/V/SO.