VP, General Manager (OC)

Alignment Healthcare USA; Orange (CA); On-site; USD 250,000 - 450,000; Full time

Job summary

Alignment Health is seeking a Vice President / Orange County General Manager to lead the Medicare Advantage business in Orange County. You will translate market strategy into business plans, drive growth, quality, and financial performance, and own the overall P&L for the market.

This executive will steer market development, STARS/quality initiatives, revenue integrity, and provider performance, collaborating with Sales, Product, Network, Contracting, Finance, and Clinical leaders to deliver

Responsibilities

• Lead annual Orange County Medicare Advantage business plan and align with enterprise strategy.
• Translate P&L targets into initiatives, milestones, forecasts, and deliverables.
• Own daily execution of plans for revenue, MLR, membership, and provider economics.
• Develop business plans by major provider, geography, product, and membership segment.
• Maintain market scorecards and lead reviews with corrective action.
• Escalate risks with recommended recovery plans and ensure financial targets.
• Drive growth, retention, and market share through cross-functional collaboration.
• Own local execution of STARS and quality plans with enterprise teams.
• Coordinate care gaps closure and improve member outcomes.

Job description

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

The Vice President / Orange County General Manager (VP/OC GM) serves as the senior local business leader responsible for development, execution, operational performance, and financial results of Alignment Health's Medicare Advantage business in Orange County. As day-to-day general manager, this executive converts market strategy into business plans, financial objectives, operational priorities, and disciplined execution.

The role drives five primary value drivers: membership growth and retention; STARS and quality; compliant RAF and revenue integrity; provider and hospital performance; and market profitability, including a medical loss ratio (MLR) target of 87% or less, subject to quality, access, and regulatory requirements.

The VP, Market President shares in market strategy for assigned markets, enterprise alignment, and strategic priorities and resource allocation, in collaboration with the Chief of Contracting and Market Management and the company President. The VP/OC GM reports to the VP, Market President and dotted line into the Chief of Contracting is the designated Responsible executive for integrated local market execution under formal RACI governance, working in close collaboration with Sales and other functional leaders. The role operates with the ownership mindset of a local business senior level within approved decision rights.

General Duties/Responsibilities

1. Market Business Planning and P&L Execution

• Lead the annual Orange County Medicare Advantage business plan, aligning market commitments with enterprise strategy and the Market President's direction.
• Translate P&L targets into initiatives, owners, milestones, forecasts, and measurable deliverables.
• Own daily execution of approved plans for revenue, medical expense, MLR, membership, quality, risk adjustment, and provider economics.
• Develop business plans by major provider, hospital, geography, product, and membership segment.
• Maintain a market scorecard against budget, forecast, prior year, and targets; lead monthly reviews and corrective action.
• Escalate material financial, regulatory, contractual, and execution risks with recommended recovery plans.
• Primary performance commitment: Deliver approved financial results and an MLR of 87% or less.

2. RACI Governance and Execution

• Establish a formal RACI for each Orange County market initiative with one Accountable decision owner, Responsible execution owners, and Consulted/Informed stakeholders.
• Act as the Responsible executive for coordinating integrated execution across Sales, Product, Network, Contracting, Finance, Actuarial, Clinical,
• Maintain initiative roadmaps with resources, dependencies, deadlines, financial impact, and clear deliverables.
• Conduct weekly execution, monthly performance, and quarterly strategic reviews.
• Hold local and functional leaders to documented commitments; resolve barriers within delegated authority and escalated unresolved issues.
• Drive recovery plans rather than serving only as an advisor or meeting participant.

3. Membership Growth, Retention and Market Development

• Lead local growth and retention execution in collaboration with Sales, Product, Marketing, Broker Distribution, and provider leadership.
• Set growth objectives by product, provider, channel, geography, and member segment.
• Identify market share opportunities, provider partnerships, and product differentiation.
• Align network capacity, access, service, and member experience with enrollment and retention.
• Monitor enrollment, disenrollment, retention, and competitor trends; initiate recovery plans where needed.
• Ensure provider-related marketing and referral initiatives comply with CMS requirements.
• Primary performance commitment: Deliver approved net growth, retention, revenue, and market share targets.

4. STARS, Quality and Member Outcomes

• Own local execution of approved STARS and quality plans in partnership with enterprise Quality, Clinical, Pharmacy, Operations, and providers.
• Build provider-specific objectives for HEDIS, CAHPS, HOS, medication adherence, preventive care, and applicable measures.
• Coordinate internal clinicians and external provider groups to close care gaps and improve member outcomes.
• Embed quality scorecards, correcti