Market Leader - North Carolina

Company Overview

Longevity Health Plan Statement of Purpose: To improve the health and quality of life of nursing home residents by caring for their unique medical, social and emotional needs

Longevity Health Plan is a Medicare Advantage Institutional Special Needs Health Plan (ISNP) for long term nursing home residents. Longevity Health Plan covers all medically necessary and preventive services covered under Medicare Part A (Hospitalization) and Part B (Medical), and Part D (Prescription Drug). We’re focused on improving our members’ physical, mental, and social well-being through personalized clinical care and therapies.

Longevity Health Plan is growing rapidly and is looking to add new talent to our team. Longevity Health Plan currently has operations in Florida, Illinois, New Jersey, New York, North Carolina, and Oklahoma, with plans to start up operations in Michigan and additional states in the very near future. Due to our rapid growth, we have an immediate need for a Market Leader to support our Chicago, IL and Detroit, MI Markets.

Position Summary

The Market Leader provides the leadership, management and vision to effectively grow the local health plan and to support clinical efficacy, financial strength and operating efficiency.

Essential Functions

Senior market based executive responsible for plan operations and activities who is directly responsible for driving operational, financial outcomes and supporting clinical results of the local health plan in a highly matrixed environment with corporate partners. Will coordinate with Longevity Health Plan’s executive team and specifically Chief Clinical Officer and local clinical team to achieve local goals in coordination with national and corporate objectives.
Assist in the development of long range and annual targets and goals for the market.
Assist in the development of strategies to ensure continued growth and financial stability of the health plan in alignment with corporate objectives.
Monitor progress and implement changes/improvements as appropriate.
Deliver positive member experience and high family/caregiver satisfaction, including coordinating member/family communications with Longevity Health Plan and ensuring timely distribution of key notices, provider directories and required materials.
Review data as assigned to identify evolving trends through analytics provided by shared services functions.
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.
Implement 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.
Establish and maintain mutually beneficial relationships with local Skilled Nursing Facility partners and key healthcare providers in the market.
Partner with and provide both strategic and tactical direction to the provider network contracting team to ensure a strategic and CMS adequate network that meets care, service, compliance, and financial goals.
Conduct outreach to local Skilled Nursing Facilities in partnership with the Growth Team that would be a good fit to offer Longevity Health Plan’s ISNP and work with Longevity Health Plan provider network contracting team to finalize contracts. Manage on-going relationships with Skilled Nursing Facility leaders and staff in Longevity Health Plan’s network.
Create a growth plan and productivity targets for each Sales Engagement Specialist in the market to grow plan membership.
Collaborate with Longevity Health Plan and executive leadership to develop compensation plans for Sales Engagement Specialists and monitors on-going productivity against targets.
Coach Sales Engagement Specialists via weekly discussions, monitoring of delegated and internal sales process as applicable, and develops plan and activities to grow the membership in compliance with all federal and state regulations.
Oversee the delivery of key strategic initiatives and operational plans of Longevity Health Plan that drive operational quality improvement, member growth, earnings, and regulatory compliance.
Drive 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.
Participate in quality audits and leads change where appropriate in the market.
Ensure that all local staff has received required training and regularly provides feedback for all individuals supporting Longevity Health Plan operations.
In collaboration with the executive leadership team, oversee the integration and delivery of current product offerings and supplemental benefit offerings in the market.
Work with Compliance to provide strategic direction and tactical guidance to ensure full compliance with federal/state regulations and contract terms and conditions.
Understand and facilitate legislation/regulations affecting Longevity Health Plan in the market.
In coordination with Compliance, provide business leadership to all compliance reviews.
Develop and foster effective collaboration between corporate and functions managed directly by the market.
Collaborate with colleagues in operational risk, compliance, and internal audit to ensure that robust policies and procedures are maintained and that risks are identified and addressed quickly.
Oversee integration of any acquired local assets. Hires, trains and mentors local market staff and resources.
Function as a champion of Compliance and collaborate with corporate teams to ensure that local staff and providers complete initial and annual Compliance, Model of Care, HIPAA, and FWA training.
Represent Longevity Health Plan 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.

Education and Training:

MBA or advanced degree in health care management 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 plan or provider role).
Strong local market knowledge of the skilled nursing home environment and experience in Medicare Advantage marketing and sales strongly preferred.
Health plan and provider organization management experience is 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.
Strong, 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.

Candidates must meet the Company’s hiring criteria which includes a pre-employment background and drug screening.

Longevity Health Plan 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.

Longevity Health Plan offers a competitive compensation and benefits package which includes medical, dental, vision, short and long-term disability, life insurance, and 401(k).