SVP, Medicaid Divisional Leader - Humana
Louisville, KY
About the Job
Become a part of our caring community and help us put health first
The Senior Vice President (SVP), Medicaid Divisional Leader, will serve as the Divisional leader, presiding over a portfolio of Medicaid Markets with aligned Dual Eligible Special Needs Plan (DSNP) products. This role will ensure consistent and aligned strategic execution, market operations, and best practice adoption across all Medicaid markets. This executive will be responsible to oversee all stages of market maturity uniting business development, active implementation, and established markets for end to end life cycle responsibility under the Divisional leader.
As a Medicaid Executive, you will be expected to lead with a focus on financial performance, quality improvements, and state relationship management, optimizing Medicaid performance and ensuring alignment with Medicare and other Enterprise leaders.
Unified D-SNP Market Leadership
+ Oversee the Medicaid D-SNP market portfolio (IL, IN, MI, OH, VA, WI) consisting of approximately 400k members and 5BN in revenue
+ Streamline complex interactions with Medicare and Enterprise leadership by providing a single point of accountability for Medicaid D-SNP market performance and strategy
Strategic Execution & Performance
+ Ensure Medicaid Strategic Objectives are executed effectively across all aligned markets, with dedicated focus on achieving financial performance targets
+ Monitor and adapt to regulatory changes, implement rate advocacy efforts, and drive strategies for managing quality withhold and unit cost reductions
+ Leverage industry knowledge and market insights to improve operational efficiency and market performance, ensuring alignment with Medicaid and DSNP product goals.
P&L Management and Financial Strategy
+ Oversee Profit & Loss (P&L) management for all aligned Medicaid markets, ensuring financial improvement strategies are in place and performance targets are consistently met or exceeded
+ Collaborate with finance teams and market leaders to develop and execute financial strategies that enhance profitability, improve cost structure, and drive long-term sustainability in Medicaid operations
State Relationship Management & Advocacy
+ Serve as the primary advocate for the organization in each aligned state, developing and maintaining strong relationships with state regulators, policymakers, and other key stakeholders
+ Drive the organization’s rate advocacy strategy, ensuring favorable financial terms and ongoing support for Medicaid services in each market
+ Lead regulatory compliance efforts, ensuring that all Medicaid markets adhere to state and federal regulations and that strategic objectives align with evolving policy landscapes
Talent Management, Culture, and Engagement
+ Lead talent management efforts across aligned Medicaid markets, focusing on building a high-performance culture, associate engagement, and leadership development
+ Oversee recruitment, retention, and professional development efforts to ensure that teams are equipped to drive market success and adapt to the evolving Medicaid landscape
+ Foster a positive associate culture by driving initiatives that promote employee engagement, collaboration, and alignment with organizational values and goals.
Use your skills to make an impact
Required Qualifications
+ Bachelor’s degree in Business, Healthcare Administration, or related field required; advanced degree (MBA, MHA, or similar) strongly preferred
+ 10+ years of experience in Medicaid or healthcare leadership, with a focus on managing market-level operations, P&L oversight, and state relationships
+ 8 + years of people leadership with proven success in expanding and elevating the capabilities and performance of a multi-level team and large-scale organization.
+ Proven ability to lead complex, multi-state Medicaid/Medicare markets and drive consistent execution of business objectives
+ Strong track record of success in managing Medicaid and/or Medicare and DSNP product strategies, as well as financial improvement initiatives
+ Demonstrated experience in advocacy, regulatory compliance, and stakeholder relationship management at the state and federal levels.
+ Strong leadership and team-building skills, with the ability to manage a large, geographically dispersed team and foster a unified organizational culture
+ Deep understanding of Medicaid and/or Medicare, and DSNP policy, regulations, and market trends
+ Strategic thinker with excellent problem-solving skills, capable of developing innovative solutions to improve market performance and financial outcomes
+ Exceptional communication and negotiation skills, with the ability to influence and build relationships with a wide range of internal and external stakeholders
+ Location: Prefer candidate reside within the region IL, IN, MI, OH, VA, WI or Louisville, KY or Tampa FL. Will consider candidates in Central or Eastern time zones.
Additional Information
+ Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.
+ Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:Health benefits effective day 1Paid time off, holidays, volunteer time and jury duty payRecognition pay401(k) retirement savings plan with employer matchTuition assistanceScholarships for eligible dependentsParental and caregiver leaveEmployee charity matching programNetwork Resource Groups (NRGs)Career development opportunities
Scheduled Weekly Hours
40
About us
Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
The Senior Vice President (SVP), Medicaid Divisional Leader, will serve as the Divisional leader, presiding over a portfolio of Medicaid Markets with aligned Dual Eligible Special Needs Plan (DSNP) products. This role will ensure consistent and aligned strategic execution, market operations, and best practice adoption across all Medicaid markets. This executive will be responsible to oversee all stages of market maturity uniting business development, active implementation, and established markets for end to end life cycle responsibility under the Divisional leader.
As a Medicaid Executive, you will be expected to lead with a focus on financial performance, quality improvements, and state relationship management, optimizing Medicaid performance and ensuring alignment with Medicare and other Enterprise leaders.
Unified D-SNP Market Leadership
+ Oversee the Medicaid D-SNP market portfolio (IL, IN, MI, OH, VA, WI) consisting of approximately 400k members and 5BN in revenue
+ Streamline complex interactions with Medicare and Enterprise leadership by providing a single point of accountability for Medicaid D-SNP market performance and strategy
Strategic Execution & Performance
+ Ensure Medicaid Strategic Objectives are executed effectively across all aligned markets, with dedicated focus on achieving financial performance targets
+ Monitor and adapt to regulatory changes, implement rate advocacy efforts, and drive strategies for managing quality withhold and unit cost reductions
+ Leverage industry knowledge and market insights to improve operational efficiency and market performance, ensuring alignment with Medicaid and DSNP product goals.
P&L Management and Financial Strategy
+ Oversee Profit & Loss (P&L) management for all aligned Medicaid markets, ensuring financial improvement strategies are in place and performance targets are consistently met or exceeded
+ Collaborate with finance teams and market leaders to develop and execute financial strategies that enhance profitability, improve cost structure, and drive long-term sustainability in Medicaid operations
State Relationship Management & Advocacy
+ Serve as the primary advocate for the organization in each aligned state, developing and maintaining strong relationships with state regulators, policymakers, and other key stakeholders
+ Drive the organization’s rate advocacy strategy, ensuring favorable financial terms and ongoing support for Medicaid services in each market
+ Lead regulatory compliance efforts, ensuring that all Medicaid markets adhere to state and federal regulations and that strategic objectives align with evolving policy landscapes
Talent Management, Culture, and Engagement
+ Lead talent management efforts across aligned Medicaid markets, focusing on building a high-performance culture, associate engagement, and leadership development
+ Oversee recruitment, retention, and professional development efforts to ensure that teams are equipped to drive market success and adapt to the evolving Medicaid landscape
+ Foster a positive associate culture by driving initiatives that promote employee engagement, collaboration, and alignment with organizational values and goals.
Use your skills to make an impact
Required Qualifications
+ Bachelor’s degree in Business, Healthcare Administration, or related field required; advanced degree (MBA, MHA, or similar) strongly preferred
+ 10+ years of experience in Medicaid or healthcare leadership, with a focus on managing market-level operations, P&L oversight, and state relationships
+ 8 + years of people leadership with proven success in expanding and elevating the capabilities and performance of a multi-level team and large-scale organization.
+ Proven ability to lead complex, multi-state Medicaid/Medicare markets and drive consistent execution of business objectives
+ Strong track record of success in managing Medicaid and/or Medicare and DSNP product strategies, as well as financial improvement initiatives
+ Demonstrated experience in advocacy, regulatory compliance, and stakeholder relationship management at the state and federal levels.
+ Strong leadership and team-building skills, with the ability to manage a large, geographically dispersed team and foster a unified organizational culture
+ Deep understanding of Medicaid and/or Medicare, and DSNP policy, regulations, and market trends
+ Strategic thinker with excellent problem-solving skills, capable of developing innovative solutions to improve market performance and financial outcomes
+ Exceptional communication and negotiation skills, with the ability to influence and build relationships with a wide range of internal and external stakeholders
+ Location: Prefer candidate reside within the region IL, IN, MI, OH, VA, WI or Louisville, KY or Tampa FL. Will consider candidates in Central or Eastern time zones.
Additional Information
+ Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.
+ Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:Health benefits effective day 1Paid time off, holidays, volunteer time and jury duty payRecognition pay401(k) retirement savings plan with employer matchTuition assistanceScholarships for eligible dependentsParental and caregiver leaveEmployee charity matching programNetwork Resource Groups (NRGs)Career development opportunities
Scheduled Weekly Hours
40
About us
Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
Source : Humana
