President, Marketplace

Role and Responsibility:
•Executive responsible for the Marketplace P&L, product design, membership growth, quality, outcomes and overall product strategy to achieve corporate and health plan objectives
•Coordinate across health plans, the formulation of strategy for Marketplace products
•Collaborate with health plans and functional departments on the design and development of Marketplace products
•Partner with health plan presidents to develop operating targets (budget, membership, quality goals) to ensure product success
•Champion innovative Marketplace programs and initiatives
•Oversee the development and product performance of Marketplace products from plan design, consumer experience, quality, network development, eligibility, enrollment, sales /marketing clinical and financial management
•Maintain knowledge of key CMS regulations and ensure operationalization of requirements
•Maintain current and accurate knowledge of coverage expansion, insurance market reforms and ACA issues
•Complete modeling and analysis of member population for subsidized coverage and direct consumer segmentation and research
•Accountable for product performance (P&L, market share, operating targets, membership, consumer experience, quality and accreditation)
•Collaborate with key stakeholders on consumer information and enrollment platform
•Develop rate setting processes, plan design, sales strategy
•Determine provider network strategy to drive performance and achieve outcomes
•Perform any other job related instructions, as requested

Key Decision Rights:
•Strategy and product model
•Annual budget and operating plan
•Hiring staff

Cross Functional Interactions:
•Interact heavily with health plan presidents
•Interact with functional owners of business partner organizations

Education / Experience:
•Bachelor’s degree is required
•Master’s in Business Administration (MBA), Healthcare Administration and/or other related discipline is preferred
•A minimum of six (6) years of experience in health plan product development or product management is required
•Commercial insurance experience is required and expertise around Exchange products is strongly preferred
•Prior experience working with state government is preferred

Required Competencies / Knowledge / Skills:
•Commitment to the mission and values of the CareSource Family of Companies
•Desire to take a hands-on, operational approach
•Strong understanding of healthcare finances
•Strong collaborative skills, working with cross-functional stakeholders and external partners
•Effective oral and written communication skills
•Ability to develop and maintain strong relationships with local stakeholders
•Strong relationships with local stakeholders
•Desire to take a hands-on, operational approach

Licensure / Certification:

•Marketplace P&L and membership of all associated products
•Operational financial targets
•CMS & member satisfaction
•Quality and clinical outcome targets

Working Conditions:
•General office environment; may be required to sit/stand for long periods of time

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