Regional VP - Market Strategy and Business Development

Job Number: 2881

Workplace Type:

Position Title: Regional Vice President

External Description:

Regional VP - Market Strategy and Business Development

Alignment Healthcare was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time.

By becoming a part of the Alignment Healthcare team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment community.

 

Position Summary:
Reporting to the SVP of Business Development, the role of Regional VP - Market Strategy and Business Development will be responsible for the development and subsequent execution of a successful new market entry for Alignment Healthcare. 

This position requires a unique individual, one with a proven track record and a willingness to work and build from the ground up.  An individual with an ability to navigate and evaluate current market dynamics, a history of strong healthcare relationships in the geography and a desire to expand and grow the market footprint, are all needed to be successful in this role.

Our goal is to validate and refine our scalable and repeatable market entry playbook, which we have utilized in current markets we are operating in today.  Specifically, this role will establish and evolve successful network contracting strategies and business development initiatives. 

Working closely with the national Business Development leadership team, s/he will lead the market’s contracting activity to secure quality, cost effective provider networks to deliver competitive Medicare Advantage benefits to Alignment’s members.  This person will also lead the expansion of strategic relationships with major health systems and local and national primary care organizations.

General Duties/Responsibilities:

(May include but are not limited to)

• Identifies, evaluates, develops and executes network development strategies in established and new markets that support local market initiatives and corporate goals.
• Creates Market BluePrints detailing network strategies needed to build efficient and effective PCP, Specialists, and Hospital networks.
• Will work collaboratively with the National Contracting organization to execute the initial network development plan and ensure network adequacy for both state and CMS requirements.
• Create contingency market planning scenarios over a 3- and 5-year horizon, to provide optionality and phased approach to both member growth and network sustainability.
• Negotiates, implements, and manages national agreements, statewide and system contracts, supplemental and vendor contracts, as well as IPA, Hospital and ancillary agreements in local markets in accordance with corporate standards, including network adequacy requirements and performance targets.
• Analyzes current and projected network needs from cost, utilization, performance, network adequacy, competitor and regulatory perspectives to refine network strategy goals for the organization in a proactive and innovative manner.
• Negotiates all compensation methodologies including but not limited to capitation, per diems, case rates and incentive programs.
• Develops new reimbursement models and innovative programs, in concert with leadership, to align incentives with providers and drive optimal performance.
• Conducts contract modeling and analysis in coordination with Finance to align with budgeted trends.
• Works closely with Network Operations Team to ensure the successful administration of the contracts to ensure optimal financial and operational results, identifies outlier performance trends, and develops and implements remediation strategies to restore favorable performance.
• Collaborates with Product Management in the design of supplemental benefit offerings and the financial analysis of the supplement benefits for the CMS bid filing.
• Negotiates and implements national vendor agreements in support of Alignment clinical and operational initiatives.
• Works closely with the VP Network Management, Senior Medical Officers and other department leaders to ensure overall success of the market.
• Collaborates with the regional executive team and other departments to ensure the contracted network supports operating goals, including STARS, HEDIS, RAF, member satisfaction and other initiatives.
• Participates in market operating reviews and leads network performance executive meetings with regional and corporate leaders. Collaborates and contributes on the completion of key deliverables to meet and/or exceed budget and operating goals.
• Develops strong relationships with key provider stakeholders.
• Manages performance, mentors and develops assigned staff; recruits new staff as needed.
• Recommends and establishes department metrics. Sets goals for staff and the market.
• Contributes expertise to development of organizational best practices.

Supervisory Responsibilities:

Oversees assigned staff. Responsibilities include: recruiting, selecting, orienting, and training employees; assigning workload; planning, monitoring, and appraising job results; coaching, counseling, and disciplining employees.

 

Minimum Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Minimum Experience:
   1. 7 years of experience in managed care or health care field, including a strong understanding of reimbursement methodologies, contract language, negotiation strategies, financial modeling and analysis, managed care and Medicare Advantage plans; or any combination of education and experience, which would provide an equivalent background
2. Education/Licensure:

1. 1. Requires a BA/BS
   2. MBA strongly preferred

1. Other:
   1. Strong management skills
   2. Strong knowledge of Medicare managed care.
   3. Network relationship knowledge and skills.
   4. Strong analytical skills
   5. Excellent knowledge of hospitals and managed care finance and contracts
   6. Excellent executive interpersonal and relationship management skills
   7. Excellent oral, written and presentation skills
   8. Proven ability to foster collaboration, value others perspective and gain support and buy-in for organization proposal.
   9. Excellent Microsoft Office skills, including Word and Excel
   10. Experience with delegated and non-delegated providers
   11. Ability to travel by car or air
   12. Available for evenings/weekends and extended work hours as needed

1. Work Environment
2. 1. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. The role will require employee to Work At Home (WAH) in the designated geography with infrequent travel, expected to be less than 15% of work year.
2. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
3. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.

If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact [email protected].

City: Remote-Henderson

State: Nevada

Location City: Remote-Henderson

Location State: Nevada

Community / Marketing Title: Regional VP - Market Strategy and Business Development

Company Profile:

By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture, Alignment Health is revolutionizing health care for seniors! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?

At Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that’s in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career – with us.

EEO Employer Verbiage:

 

Please note: All clinical positions are contingent upon successful engagement with Alignment Health’s COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].