Vice President, Market - Tennessee - Longevity Health Plan
N/A, TN
About the Job
General Purpose: The individual holding this position is required to support and demonstrate their commitment to the Longevity Health Statement of Purpose, which is: To improve the health and quality of life of nursing home residents by caring for their unique medical, social and emotional needs.
Longevity offers an integrated health plan care management platform designed to improve clinical outcomes and reduce unnecessary medical interventions for long-term care beneficiaries living in skilled nursing facilities (SNFs). We offer Institutional Special Needs Plans (I-SNP) that are designated Medicare Advantage plans targeted to beneficiaries with Medicare part A & B who require long-term care in institutional settings. Longevity provides an advanced practice practitioner (NP or PA) supported by LHP RNs and other LHP Clinical team members to work with facility staff, physicians, and caregivers to manage member care in place, and improve their clinical outcomes. I-SNP and the Advanced Practitioner Provider/Clinical Team will improve resident and family satisfaction by providing enhanced benefits specifically tailored to the needs of facility residents.
Job Summary:
The Market Vice President is a senior market-based executive that provides leadership, management, and vision to effectively grow the local health plan, ensure operational effectiveness and efficiency, clinical outcomes optimization, financial strength. The Market Vice President is responsible for Health Plan operations and activities, is directly responsible for driving operational, financial outcomes and to support clinical results of the local health plan, working in a highly matrixed environment with corporate partners. Will coordinate with Longevity Health’s executive team and specifically Chief Clinical Officer and local clinical team to achieve local goals in coordination with national and corporate objectives. The Market Vice President must reside in the state in which the Health Plan is licensed.
Key Tasks and Responsibilities:
- Establishes and maintains mutually beneficial relationships with local Skilled Nursing Facility partners and key healthcare providers in the market.
- Drives laser focus on improving the quality, affordability, and experience of health care for all patients as well as a relentless focus on improving the care delivery experience for providers.
- Oversees the delivery of key strategic initiatives and operational plans of Longevity Health that drive operational quality improvement, member growth, earnings, and regulatory compliance.
- Monitors key metrics and trends in sales, risk scores, utilization, unit cost, clinical key performance indicators and other business drivers to understand the impact these factors have on financial performance and drive necessary actions to achieve performance objectives.
- Assists in the development of strategies to ensure continued growth and financial stability of the health plan in alignment with corporate objectives.
- Collaborates with Finance and Performance Analysis teams to identify cost savings initiatives and monitor contract performance.
- Controls expenses by gathering and submitting budget information, scheduling expenditures, monitoring variances, and implementing corrective actions.
- Implements operational changes in the market in concert with corporate and vendor operations to achieve financial and operations goals for both for the local plan in alignment with other Longevity plans nationwide.
- Provides strategic/tactical direction and support to Network contracting team to ensure a strategic and CMS adequate network that meets care, service, compliance, and financial goals.
- Develops market team facility visit schedules, assigns, and monitors work, ensures appropriate resources, implements productivity standards, resolves operations problems, maintains reference manuals, and implements new procedures.
- Maintains working knowledge of all market key metrics including MLR, APK, IP/OP costs, Admin costs, Hospice population, etc.
- Maintains documentation of market-based strategies and current partner interactions, barriers, action plans, etc. in order to drive increased engagement and high levels of I-SNP penetration.
- Assists in the development of market and building-specific monthly/annual enrollment targets.
- Supports Growth/BD Teams in communication to local Skilled Nursing Facilities that would be a good fit to offer Longevity Health’s ISNP.
- Oversees implementation of new partner Skilled Nursing Facilities utilizing market team and corporate resources as needed, setting go-live dates, and ensuring necessary network agreements and clinical resources are in place.
- Creates an enrollment plan and productivity targets for each Sales Engagement Specialist in the market to grow plan membership.
- Collaborates with Longevity Health and executive leadership to develop compensation plans for Sales Engagement Specialists and monitors on-going productivity against targets.
- Develops materials and presents during Monthly Operating Review meetings, Business Development meetings and partner-facing Joint Operating Committee meetings.
- Maintains a regular visit schedule for assigned SNFs, visiting each at least quarterly and ensuring ongoing communication with all relevant owner/operator teams.
- In collaboration with the executive leadership team, oversees the integration and delivery of current product offerings and supplemental benefit offerings in the market.
- Understands and facilitates legislation/regulations affecting Longevity Health in the market.
- Develops and fosters effective collaboration between corporate and functions managed directly by the market.
- Collaborates with colleagues in operational risk, compliance, and internal quality audit to ensure that robust policies and procedures are maintained and that risks are identified and addressed quickly.
- Functions as a champion of Compliance and collaborates with corporate teams to ensure that local staff and providers complete initial and annual Compliance, Model of Care, HIPAA, and FWA training.
- Represents Longevity Health both in external in external forums and develop the Longevity Health Plan brand with regulators, providers, AHCA, and local healthcare partners.
- Performs other related duties as assigned.
Licensure:
- Licensure is not required for this position but preferred. LNHA, Health Insurance License or Clinical board certification/license is highly preferred.
- Valid state driver’s license with a good driving record and proof of automobile insurance required.
- Auto liability insurance declaration page with minimum limits of $100,000/$300,000 for bodily injury and $100,000 for property damage with combined single limit of $300,000. You will be responsible for providing this proof of coverage on an annual basis.
Education and Training:
- MBA, MSN or advanced degree in health care management, nursing with business education or other relevant technical or operations field preferred.
Knowledge and Experience:
- Minimum of 5-10 years of health care industry experience, with Medicare expertise required (either through health plan or provider organization).
- Strong local market knowledge of the skilled nursing home environment and experience in Medicare Advantage marketing and sales strongly preferred.
- Understanding of functional areas and their impact on overall performance (beyond operations, including clinical, finance, IT, compliance, and legal).
- Knowledge of the evolving health care delivery system, including expertise in population health management, Medicare health plan operations and value-based care delivery models, as well as a passion for improving the quality and affordability of health care for the frail and elderly living in nursing homes strongly preferred.
- Strong entrepreneurial drive along with the operational skills needed to consistently drive results.
- Excellent written and oral communication skills with internal and external business partners and employees.
- Independent decision-maker and calculated risk-taker.
- Strong strategic and analytical orientation with the ability to drive operational excellence and strong business performance.
- Ability to maintain relentless personal and team focus on achieving long-term objectives in the face of potential distractions.
- Excellent planning and problem-solving skills that enable quick identification and efficient resolution of issues.
- Highly collaborative with the ability to influence others and build strong professional relationships, especially in a highly matrixed organization.
Company Overview:
Longevity Health is a clinical services company and national Institutional Special Needs Plan (ISNP) founded with the purpose of optimizing the quality of life for people in long-term care by focusing on their individualized health needs.
Launched in 2018, our ISNP was designed to address the significant unmet needs of nursing home residents by establishing collaborative, value-based partnerships with long-term care facilities.
Between 2018 and 2022, we experienced rapid growth and expanded our ISNP offerings across several states, including Colorado, Florida, Illinois, Michigan, New Jersey, New York, and North Carolina. In 2023, we diversified our services by launching as an Independent Provider Association (IPA) in collaboration with leading national health insurers. This model is now available in Ohio, Pennsylvania, upstate New York, Georgia, South Carolina, Virginia, and Texas, with plans to expand into additional states.
These strategic partnerships allow us to deliver an elevated level of care to this vulnerable population. We are currently active in 13 markets and continue to see steady growth.
Purpose: The individual holding this position is required to support and demonstrate their commitment to the Longevity Health & LiveWell Choice Statement of Purpose, which is: To optimize the quality of life of people in long-term care by focusing on their individualized health needs through collaborative value-based solutions.
Company Disclaimers:
Longevity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.
It is the policy of Longevity Health to follow Federal and / or State regulations surrounding COVID vaccinations. While CMS guidelines have been relaxed, there are some LHP facilities which will still require staff be vaccinated in an effort to protect the health of the members / patients we serve. If your assigned location(s) require all staff to be fully vaccinated, you are required to obtain and / or provide documentation related to your COVID vaccination. To confirm whether your assigned location(s) require COVID vaccinations, please refer to the Facility Guide Job Aid located on Longevity Health Plan’s intranet site.
The Company will engage in an interactive process with individuals who cannot be vaccinated for medical or sincerely held religious beliefs to determine if a reasonable accommodation can be made. While an exemption/accommodation may be initially granted, if at any time during employment, it is determined that an exemption/accommodation that has been granted is no longer considered a reasonable accommodation, it can result in employment with the Company ending.
Candidates must meet the Company’s hiring criteria which include a pre-employment background and drug screening.
Longevity Health offers a competitive compensation and benefits package which includes medical, dental, vision, short and long-term disability, life insurance, and 401(k).
Submission of false information during the application process may result in immediate termination of employment without notice.