SVP, Health Plan Services

WelbeHealth is a value-based healthcare organization that’s transforming the future of senior care by providing an all-inclusive care option to our most vulnerable senior population.

The Senior Vice President (SVP), Health Plan Operations is the strategic and operational leader of WelbeHealth’s health plan, and a critical senior leader for the enterprise as a whole. The SVP, Health Plan Operations is accountable for maturing and scaling the WelbeHealth plan to ensure high-quality, cost-effective care for participants with high compliance as WelbeHealth continues its rapid pace of growth.

Essential Job Duties:

· Oversee health plan operations including strategy, execution, performance and compliance of all health plan functions, as well as participate in and influence strategic planning and broader WelbeHealth initiatives, ensuring that the health plan needs and strategy are considered and prioritized appropriately

· Build a deep understanding of the PACE model and implications for health plan operations in the PACE context

· Demonstrate exemplary financial acumen, maintaining a strong relationship and communication with the finance team to ensure alignment, planning, and shared insight across functions

· Owns all end-to-end core health plan processes, working with teams to ensure processes are streamlined and optimally designed for scale and tech-enablement

· Partner with IT team to co-build and jointly own HPS technology roadmap, ensuring WelbeHealth is leveraging technology effectively to scale our health plan operations, decrease risk of errors, and increase performance

· Hire, develop, inspire, and invest in the successful careers of top HPS talent and other key talent in the function

· Ensures WelbeHealth’s “beyond reproach” compliance with applicable federal, state, and local regulatory and licensing standards, as well as maintain knowledge of the regulatory and external landscape to ensure alignment with best practices

Job Requirements:

· Bachelor’s degree in healthcare administration, public health, business, social welfare, gerontology, or relevant field; MBA, MHA, or master-level equivalency strongly preferred

· Five (5) years of experience leading a $100 million+ health insurance function with P&L accountabilities, with a consistent track record of driving initiatives that improve operations effectiveness and patient experience

· Ten (10) years of relevant professional experience and knowledge of managed care, including Medicaid, that includes health plan operations, medical management, clinical review criteria, processes, and techniques

· Experience working with CMS, state health and human service department regulators, and other government stakeholders

· Experience directly leading teams and owning team outcomes across at least three (3) of the four (4) core HPS teams – network, provider partnerships, claims processing and eligibility & reconciliation

· Demonstrated ability to hire top talent, build high performing teams, and mentoring and developing high potential leaders

· Must be willing to work a varied schedule that may include evenings, weekends, and overtime

· Preference for a candidate located in or willing to relocate to within an hour of a current or future WelbeHealth location

Benefits of Working at WelbeHealth: Apply your expertise in new ways as we rapidly expand. You will have the opportunity to design the way we work in the context of an encouraging and loving environment where every person feels uniquely cared for.

· 401k + employer match

· Medical insurance coverage (Medical, Dental, Vision) starting day one of employment

· Work life balance – 17 days of personal time off (PTO), 12 holidays observed annually, and six sick days

· And additional benefits

Salary/Wage base range for this role is $300,000 - 350,000 / year + Bonus + Equity. WelbeHealth offers competitive total rewards package that includes, 401k match, healthcare coverage and a broad range of other benefits.  Actual pay will be adjusted based on experience and other qualifications.

COVID-19 Vaccination Policy

At WelbeHealth, our mission is to unlock the full potential of our vulnerable seniors. In this spirit, please note that we have a vaccination policy for all our employees and proof of vaccination, or a vaccine declination form will be required prior to employment. WelbeHealth maintains required infection control and PPE standards and has requirements relevant to all team members regarding vaccinations.

Our Commitment to Diversity, Equity and Inclusion

At WelbeHealth, we embrace and cherish the diversity of our team members, and we're committed to building a culture of inclusion and belonging. We're proud to be an equal opportunity employer. People seeking employment at WelbeHealth are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law.

Beware of Scams

Please ensure your application is being submitted through a WelbeHealth sponsored site only. Our emails will come from @welbehealth.com email addresses. You will never be asked to purchase your own employment equipment. You can report suspected scam activity to fraud.report@welbehealth.com