Newtown Square, PA, 19073, USA
2 days ago
Vice President Strategic Initiatives - Medicaid / Medicare MCO Experience
Your career starts now. We’re looking for the next generation of health care leaders. At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you. Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com . The **Vice President Strategic Initiatives** (VP) is a strategic leader responsible for overseeing and optimizing the operational functions across Medicaid, Medicare, and Exchange lines of business. The VP is pivotal in ensuring regulatory compliance, operational excellence, and the delivery of high-quality, cost-effective healthcare services to members. The VP will work collaboratively with cross-functional teams to drive process improvements, enhance member and provider experiences, and ensure the organization meets its growth and performance objectives. The VP will track initiative progress, overcome roadblocks, solve problems, manage conflict, and rally leaders by identifying concerns and addressing operational issues and will build a culture of change by engaging and collaborating across key stakeholders to embed change management practices and competencies across the organization. **Responsibilities:** + Develop, implement, and oversee operational strategies and processes that align with the organization’s mission, vision, and goals. + Ensure operational alignment with state Medicaid and CMS guidelines, regulatory requirements, and contractual obligations. + Partner with the executive team to define and execute strategic initiatives that promote growth, operational efficiency, and innovation. + Foster cross-functional collaboration to integrate operations, break down silos, and enhance organization performance. + Analyze operational data and trends to identify opportunities for process improvements, cost efficiency, and innovation. + Utilize insights to inform strategic decision making and drive continuous operations enhancements. + Lead the adoption and integration of new technologies and systems to enhance operational capabilities and scalability. + Streamline workflows and leverage technology to improve efficiency and service quality. + Champion a member-first approach by overseeing initiatives that improve member satisfaction, engagement, and retention. + Strengthen provider relationships through effective communication, streamlined processes, and timely issue resolution. + Establish, monitor, and report key performance indicators (KPIs) and operational metrics to executive leadership and regulatory bodies.; + Ensure transparency and accountability in operational performance. + Collaborate with legal, compliance, and quality teams to proactively address operational risks and maintain audit readiness. + Ensure full compliance with Medicaid and CMS regulations, state requirements, federal guidelines, and contractual commitments. + Build capacity for change by cultivating adaptable behaviors across teams and the enterprise. + Act as a diplomat across functions and levels to foster integration, collaboration, and alignment with organizational goals. + Revise and adapt plans based on input to create a culture of continuous improvement and change readiness. + Solve complex problems, manage conflicts, and rally operational leaders to address challenges and achieve organizational objectives. + Listen actively, identify concerns, and create actionable solutions to overcome barriers and sustain momentum.; + Identify early warnings, manage risks, and track progress toward operational and strategic goals. + Overcome roadblocks, create a sense of urgency, and celebrate successes to drive organizational change and achieve results. **Qualifications / Education:** + At least ten (10) or more years of progressive leadership experience in strategic transformation, healthcare and/or business operations. + Bachelor’s Degree. **Other Skills:** + Proven expertise in strategic planning, process optimization, and team leadership, with a track record of driving measurable results. + Extensive experience leading large-scale, enterprise-wide transformation initiatives, ensuring successful implementation and adoption. + Demonstrated ability to foster cross-functional collaboration, drive alignment, and lead organizational change in complex environments. + Strong background in project management, including managing diverse teams, coordinating across functions, and ensuring effective stakeholder management. + Exceptional strategic thinking and decision-making abilities, with the capability to navigate ambiguity and deliver innovative solutions. + Proficient in change management, with the ability to influence and lead at all levels within a matrixed organization. + Comprehensive understanding of state and federal regulations, healthcare delivery models, and managed care operations, particularly in Medicaid and Medicare environments. + Advanced analytical, problem-solving, and decision-making skills, capable of interpreting complex data and driving evidence-based strategies. + Outstanding interpersonal and communication skills, with the ability to effectively engage, influence, and inspire stakeholders at all levels of the organization. **Diversity, Equity, and Inclusion** At Amerihealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve. We keep our associates happy so they can focus on keeping our members healthy. **Our Comprehensive Benefits Package** Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more. As a company, we support internal diversity through: Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.
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