Medicaid Executive Leader: SVP & President

Highmark; Pittsburgh (Allegheny County); On-site; USD 250,000 - 450,000; Full time

Job summary

Highmark is seeking a Senior Vice President (SVP) of Medicaid to lead the Medicaid & D-SNP business, shaping strategic direction, financial performance and operational execution.

This executive will oversee a high-performing team, manage relationships with state partners, providers and community stakeholders, and drive innovative, cost-effective healthcare solutions for Medicaid members, while ensuring compliance with regulatory requirements.

Qualifications

• Bachelor’s degree required in relevant field.
• Minimum 10 years of progressive leadership in Medicaid or government business.
• 7 years in health insurance leadership.

Responsibilities

• Develop and execute a comprehensive Medicaid strategic plan aligned with Highmark's mission.
• Lead clinical program development and optimization through partnerships.
• Oversee enrollment, growth, revenue management, cost control and profitability for Medicaid.
• Ensure efficient operations across enrollment, claims processing, care management and quality improvement.
• Negotiate and manage a high-quality Medicaid provider network.
• Serve as primary contact for federal and state Medicaid agencies; ensure compliance.
• Represent Highmark in Medicaid industry groups and policy discussions.
• Lead and develop a high-performing Medicaid team; coach and mentor.
• Implement community engagement initiatives addressing social determinants of health.

Skills

Medicaid leadership

Strategic planning

Regulatory compliance

Financial management

Stakeholder management

Education

Bachelor's degree in Business Administration/Management or related field

Master's degree in Healthcare Administration/Business Administration or related field

Job description

Highmark is seeking a Senior Vice President (SVP) of Medicaid to lead the Medicaid & D-SNP business, shaping strategic direction, financial performance and operational execution.

This executive will oversee a high-performing team, manage relationships with state partners, providers and community stakeholders, and drive innovative, cost-effective healthcare solutions for Medicaid members, while ensuring compliance with regulatory requirements.