General Manager, Market Development (Texas/New Mexico)

The Job

The General Manager, Market Development (internally known as Sr. Director, Market Development) will position SCAN Health Plan as a high-quality mission-driven Medicare Advantage Organization in new markets poised for member and financial growth by ensuring a compliant and desirable provider network, competitive product offerings, and a compelling market engagement / management strategy are in place.

This position plays a critical role in charting and sustaining SCAN’s success in the short and long-term in new markets by planning, building, optimizing, and representing the SCAN Health Plan’s value proposition and performance.

This position reports to the VP of Market Performance, will work cross functionally across all key areas of the company, and will likely be responsible for 2-3 direct reports.

You Will

• Responsible for participating with the VP of Market Performance to set the strategy and drive our most critical initiatives.
• Plan and define SCAN’s ideal place in the market based on thorough and ongoing market demographic evaluation and present qualitative and quantitative findings to senior leaders as required.
• Outline short and long-term strategic goals for each market and map measurable milestones, provide growth and profit projections, and consult with the VP of Market Performance and other Officers as needed.
• Develop a robust pipeline of CINs, IDNs, IPAs, and other medical provider organizations, manage and foster these relationships, and ensure associated contracts are financially viable and produce a desirable network for members that meets adequacy.
• Work across major functional areas such as STARs, Risk Adjustment, Sales, Finance, and others to champion appropriate new market leading and lagging performance indicators, drive market results to optimal levels, and to assist in goal setting activities.
• Develop Sales and Marketing growth initiatives and broker relationships.
• Work with and support the CMO and Health Care Services in clinical and medical management initiatives that promote cost effective and quality outcomes.
• Actively participate in the annual bid process for assigned markets to provide guidance and perspective on what will drive success in the following CMS plan year.
• Collaborate with internal and external stakeholders to identify and pursue opportunities for service area and product expansions.
• Achieve positive team results by communicating job expectations; planning, monitoring, and appraising job results, coaching and counseling employees, maintaining policies and procedures, retaining and attracting high performing contributors, and driving employee engagement.
• Participate in civic events and other activities consistent with the organization’s social interests and supports SCAN’s mission.
• Demonstrates SCAN’s organizational values while performing all responsibilities and in all interactions with stakeholders.

Ensures accountability at all levels for areas of responsibility. Fosters a culture of respectful speaking up including collaborative debate and exploring multiple opposing views where appropriate.

• Maintain professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, and by participating in professional societies.
• Actively support the achievement of SCAN’s Vision and Goals.
• Other duties as assigned.

Your Qualifications

Bachelor's Degree in business or health field, required. Master's Degree preferred.

10+ years managed care required

5+ years executive level position required

Knowledge of CMS and DHCS required

Must understand how to operate Medicare Advantage at the local level

Must be familiar with Texas (San Antonio / Houston) and New Mexico (Albuquerque) markets

Occasional travel as needed

What's in it for you?

• Base Pay Range : $177,500 to $284,000 annually
• Work Mode : Mostly Remote
• An annual employee bonus program
• Robust Wellness Program
• Generous paid-time-off (PTO)
• 11 paid holidays per year, 1 floating holiday, birthday off, and 2 volunteer days
• Excellent 401(k) Retirement Saving Plan with employer match
• Robust employee recognition program
• Tuition reimbursement
• An opportunity to become part of a team that makes a difference to our members and our community every day!
30+ days ago