Job Description

POSITION OVERVIEW

The VP, Regulated Markets role is a key leadership position reporting to the Senior Vice President PBM Account management Health Plan. The VP is responsible for the development and execution of business strategies for the Medicare, Medicaid, Healthcare Reform and PDP book of business, including membership growth, contribution margin, quality and compliance. Will manage key federal and state regulatory and legislative relationships in order to proactively address issues such as covered populations, eligibility, benefit design, networks, and new products. Will serve as SME and company representative to the state and federal government agencies, legislators, providers, and members. Retention of clients while maintaining excellence in CMS audit results will be critical. Proven leader with ability to lead both direct reports and cross functional relationships in the organization. Accountability for developing others and managing performance, identifying key talent/high potentials, and creating a high performing and engaging culture.

• This leader will serve as the voice of the regulated marketplace, CMS and all regulations; they will provide leadership and direction in the overall performance of government programs including Medicaid, Medicare, HCR and PDP to ensure execution of strategies, appropriate financial performance, and delivery against service and quality goals while remaining proactively abreast of current and future regulation and guidelines as they relate to changes which might impact the business.

• This leader will be focused on existing and prospect strategies for winning and retaining business; they will drive revenue growth in a profitable manner while focusing on quality, compliance and superior service.

• This leader will be responsible for leading the Regulated Market product strategy to ensure what is being delivered to prospective clients proactively meets their needs and differentiates in the marketplace.

• Proactively identify opportunities that can quickly turn into execution plans that drive top and bottom-line performance results, including development of appropriate financial models and key performance indicators, in conjunction with cross-functional partners.

• Manage key federal and state regulatory and legislative relationships in order to proactively address issues such as eligibility, benefit design, networks, and new products. Serve as liaison to the state and federal governments, providers, members, and community groups.

• Ensure all compliance programs and reporting mechanisms are updated and in line with all guidelines.

• Serve as a key member of the SAM leadership team in addressing corporate-wide issues, developing strategy, and building a culture of partnership and accountability.

• Collaborate and strategize with peers and teams across matrixed organization.

• Recruit, motivate, engage and retain a highly competent and productive team. Create a working environment where operational excellence, innovation and personal growth are encouraged and realized.

• Guide the identification and implementation of business process improvements and optimization across lines of business and the organization.

QUALIFICATIONS

Education:

• Bachelor\'s degree, preferably a master\'s degree in business, health administration, or a related field

Experience:

• A track record of at least 15 years of progressively responsible leadership roles, culminating in at least five years in an executive role with demonstrated experience and success in managing through complex, matrixed organizations.
• Deep understanding of government regulated marketplace including Medicaid, Medicare and Healthcare reform.
• Demonstrated success facilitating strong external/internal working relationships.
• A track record of developing leaders within prior organizations
• A record of success in growing respective book of business
• Astute financial acumen. Effectively manage P&L and cross-functional support in a matrixed organization revolving around government services.

Competencies/Behaviors:

• Results focused strategic thinker, who brings discipline, drive and accountability to deliver.
• Ability to develop and drive a plan from creation to execution in an organic growth environment.
• Entrepreneurial leader who understands the healthcare landscape
• Builds motivated, high performing teams, inspires organization to perform at higher level.
• Strong communicator, with ability to tailor message to the audience
• Politically astute and aware internally and externally
• Embraces and encourages diversity in styles and thought leadership.
• High energy, data driven and ability to operate in a fast-paced environment.
• Personal integrity that embodies high standards and commitment to excellence

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

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