VP, Health Plan Product Strategy for Medicare/Medicaid

VNS Health; New York (NY); On-site; USD 194,000 - 258,000; Full time

Job summary

VNS Health seeks a strategic, senior product leader to steer the Medicare/MLTC portfolio for New York. You will translate market and member insights into a cohesive product strategy across clinical, operational, network, sales and community functions.

You will guide investments, oversee CMS bid cycles and ensure regulatory alignment and financial sustainability, partnering with senior leaders across the organization.

Qualifications

• Ten years of progressive managerial experience in health care administration.
• Leadership in health insurance or managed care with product strategy responsibility.
• Ability to lead cross-functional product decisions and translate policy/market developments into action.
• Experience across Finance/Actuarial, Clinical, Network, Operations, Sales with gov-sponsored managed care knowledge.
• Proven ability to influence senior leaders and drive product improvements.
• Experience developing professionals or cross-functional teams in a complex organization.

Responsibilities

• Establishes and implements a one-to-three-year strategy for the assigned product portfolio.
• Leads product development, enhancement, positioning and lifecycle decisions.
• Integrates product strategy with operations, provider network, clinical programs, sales, community engagement and member experience.
• Recommends product priorities and significant tradeoffs to Health Plans executive leadership.
• Establishes product performance expectations and partners with Finance, Actuarial and Analytics to assess membership, retention, revenue, margin, utilization, quality and experience measures.
• Leads cross-functional review of product results, identify root causes of performance gaps and direct development of corrective strategies and product improvements.
• Develops and presents business cases for product investments, benefit or program changes and growth opportunities.
• Evaluates the operational and financial consequences of policy, benefit, network and service changes and recommend approaches that improve overall product performance.
• Provides senior product leadership across functional boundaries, establishing shared priorities, decision processes, implementation accountabilities and escalation paths for material product initiatives.
• Partners with Clinical, Operations, Network, Finance, Actuarial, Sales, Community, Technology, Compliance, Government Affairs and other stakeholders to translate product direction into executable plans.
• Serves as a senior advisor on assigned product strategy and represent the product function in leadership discussions and appropriate external engagements.
• Works in tandem with the counterpart Medicare or Medicaid product VP to coordinate decisions affecting dual-eligible populations, product transitions and the continuum of services.
• Leads and develops assigned product-management resources and capabilities, including performance expectations and talent development, consistent with the final approved organizational structure.
• Directs Medicare Advantage and applicable Special Needs Plan product strategy, benefit design, competitive positioning and ongoing portfolio optimization.
• Leads product-side planning and governance for the annual CMS bid and benefit cycle in partnership with Actuarial, Finance, Pharmacy, Clinical, Network, Operations and Compliance.
• Assesses Medicare policy, bid economics, market dynamics and member needs to guide benefit, service-area and product investment recommendations.
• Directs Medicaid and MLTC product strategy, including product integration, program development and alignment with LTSS and complex member needs.
• Assesses New York State Medicaid and MLTC policy, contractual requirements, procurement opportunities and program changes; translate implications into product and cross-functional operational strategies.
• Guides product approaches to community needs, access, long-term care and the interaction between Medicaid and Medicare coverage for eligible populations.
• Participates in special projects and performs other duties as assigned.

Skills

Medicare Advantage

CMS bid management

Cross-functional leadership

Product strategy

Regulatory knowledge

Education

Bachelor's Degree in Business, Healthcare Administration, Public Health, Finance or related field

Master's Degree in Business, Healthcare Administration, Public Health, Finance or related field

Job description

VNS Health seeks a strategic, senior product leader to steer the Medicare/MLTC portfolio for New York. You will translate market and member insights into a cohesive product strategy across clinical, operational, network, sales and community functions.

You will guide investments, oversee CMS bid cycles and ensure regulatory alignment and financial sustainability, partnering with senior leaders across the organization.