Senior VP, Medicaid Strategy & Growth

Highmark Health / AHN; Pittsburgh (Allegheny County); On-site; USD 300,000 - 600,000; Full time

Job summary

Highmark Inc. seeks a Senior Vice President of Medicaid to lead strategic direction and financial performance for its Medicaid and D-SNP business.

This executive will oversee a high‑performing team, drive innovation in service delivery, and manage relationships with state partners, providers, and community stakeholders. The SVP will shape policy, monitor KPIs, control costs, and ensure compliance with federal and state requirements while expanding access and improving member outcomes across

Qualifications

• Must have 10+ years of progressive leadership in the Medicaid or related government business.
• 7 years in health insurance leadership.
• 5 years of effective P&L management or related financial management.
• Master's degree preferred.
• Experience securing and operating across multiple states and contracts preferred.

Responsibilities

• Develop and execute a comprehensive strategic plan for the Medicaid line of business.
• Lead clinical programs and optimization to improve quality and cost outcomes.
• Oversee enrollment, claims processing, care management, and quality improvement.
• Drive financial performance, revenue growth, cost control, and KPI monitoring.
• Negotiate contracts with hospitals, physicians, and other providers.
• Maintain strong relationships with federal/state Medicaid agencies and regulators.
• Represent Highmark in Medicaid industry groups and policy discussions.
• Build and develop a high-performing Medicaid team.
• Lead community engagement initiatives addressing social determinants of health.

Skills

Medicaid knowledge

Regulatory compliance

Financial acumen

Leadership

Stakeholder engagement

Education

Bachelor’s degree in Business Administration/Management, Healthcare/insurance related field

Master's degree in Healthcare Administration, Business Administration, or a related field

Job description

Highmark Inc. seeks a Senior Vice President of Medicaid to lead strategic direction and financial performance for its Medicaid and D-SNP business.

This executive will oversee a high‑performing team, drive innovation in service delivery, and manage relationships with state partners, providers, and community stakeholders. The SVP will shape policy, monitor KPIs, control costs, and ensure compliance with federal and state requirements while expanding access and improving member outcomes across