Scott and White Health Plan offers individual and family plans, fully insured and self-funded plans for small and large employers, Medicare Advantage and Prescription Drug plans, and Medicaid plans, serving 360,000+ members across 171 counties in North, West, and Central Texas. The 2019-2020 National Committee for Quality Assurance (NCQA) Private Health Insurance Ratings named Scott and White Health Plan and Scott & White Care Plans as the top-rated health plans in Texas (overall rating of 4 out of 5). Scott and White Health Plan is also consistently ranked as one of the top Medicaid and Medicare Advantage payers in the state.
The Vice President of Government Programs for Scott and White Health Plan reports to the President/CEO of Scott and White Health Plan. The Vice President supervises two Directors with responsibility for Medicaid Programs and the Government Programs Exchange.
ESSENTIAL FUNCTIONS - Overall leadership direction for growth, profit/loss, for Baylor Scott & White Health Plan’s Medicare Advantage, Medicaid and Individual lines of business. - Oversees business transformation and establish new product development priorities, serving as a thought leader for the government programs market. - Drive innovation for all government programs lines of business (Medicare Advantage, Medicaid and Individual). - Collaborate with Baylor Scott & White Health System’s Value Based Care organization and their ACO (Baylor Scott & White Quality Alliance), Digital Health Office, and Health Plan Chief Operating Officer to develop solution-oriented products/services and capabilities informed by consumer research and competitive market information - Ensure skill sets and capabilities exist within teams to execute strategies through on-going coaching of individuals and teams. Attract and retain the best in the industry. - In managing a portfolio of products, maintains - An active analysis of market trends and opportunities. Requires a clear understanding of customer value propositions to differentiate Scott and White Health Plan in the marketplace - Deep understanding of the breadth of network, cost and potential pricing of recommended products and sales - Serves as liaison with the regulatory contract holder (e.g.: CMS for Medicare, Texas Health and Human Services Commission (HHSC) for Medicaid, etc.) Coordinates Scott and White Health Plan operational responses to HHSC requirements - Leads RFP and Bidding Process for Governmental Programs and develops operational policies, procedures and standards related to government health care programs and directs implementation, maintenance, ongoing review and process improvement
REQUIREMENTS - Bachelor’s degree and 10+ years of relevant experience - A track record of success in leading government programs within a national or regionally-based health plan - Demonstrated experience in guiding complicated Medicaid and Medicare bid processes including developing overall strategy, writing the RFP, interfacing with consultants when needed - Must live in Central Texas and office out of Austin or Temple, Texas
Baylor Scott & White Health (BSWH) is the largest not-for-profit health care system in Texas and one of the largest in the United States. With a commitment to and a track record of innovation, collaboration, integrity and compassion for the patient, BSWH stands to be one of the nation’s exemplary health care organizations. Our mission is to serve all people by providing personalized health and wellness through exemplary care, education and research as a Christian ministry of healing. Joining our team is not just accepting a job, it’s accepting a calling!