Posted on: February 22, 2021
Longevity Health Plan Statement of Purpose: To improve the
health and quality of life of nursing home residents by caring for
their unique medical, social and emotional needs Longevity Health
Plan is a Medicare Advantage Institutional Special Needs Health
Plan (ISNP) for long term nursing home residents. Longevity Health
Plan covers all medically necessary and preventive services covered
under Medicare Part A (Hospitalization) and Part B (Medical), and
Part D (Prescription Drug). We're focused on improving our members'
physical, mental, and social well-being through personalized
clinical care and therapies. Longevity Health Plan is growing
rapidly and is looking to add new talent to our team. Longevity
Health Plan currently has operations in Florida, Illinois, New
Jersey, New York, North Carolina, and Oklahoma, with plans to start
up operations in Michigan and additional states in the very near
future. Due to our rapid growth, we have an immediate need for a
Market Leader to support our Chicago, IL and Detroit, MI Markets.
Position Summary The Market Leader provides the leadership,
management and vision to effectively grow the local health plan and
to support clinical efficacy, financial strength and operating
efficiency . Essential Functions
- Senior market based executive responsible for plan operations
and activities who is directly responsible for driving operational,
financial outcomes and supporting clinical results of the local
health plan in a highly matrixed environment with corporate
partners. Will coordinate with Longevity Health Plan's executive
team and specifically Chief Clinical Officer and local clinical
team to achieve local goals in coordination with national and
- Assist in the development of long range and annual targets and
goals for the market.
- Assist in the development of strategies to ensure continued
growth and financial stability of the health plan in alignment with
- Monitor progress and implement changes/improvements as
- Deliver positive member experience and high family/caregiver
satisfaction, including coordinating member/family communications
with Longevity Health Plan and ensuring timely distribution of key
notices, provider directories and required materials.
- Review data as assigned to identify evolving trends through
analytics provided by shared services functions.
- Monitors key metrics and trends in sales, risk scores,
utilization, unit cost, clinical key performance indicators and
other business drivers to understand the impact these factors have
on financial performance and drive necessary actions to achieve
- Implement operational changes in the market in concert with
corporate and vendor operations to achieve financial and operations
goals for both for the local plan in alignment with other Longevity
- Establish and maintain mutually beneficial relationships with
local Skilled Nursing Facility partners and key healthcare
providers in the market.
- Partner with and provide both strategic and tactical direction
to the provider network contracting team to ensure a strategic and
CMS adequate network that meets care, service, compliance, and
- Conduct outreach to local Skilled Nursing Facilities in
partnership with the Growth Team that would be a good fit to offer
Longevity Health Plan's ISNP and work with Longevity Health Plan
provider network contracting team to finalize contracts. Manage
on-going relationships with Skilled Nursing Facility leaders and
staff in Longevity Health Plan's network.
- Create a growth plan and productivity targets for each Sales
Engagement Specialist in the market to grow plan membership.
- Collaborate with Longevity Health Plan and executive leadership
to develop compensation plans for Sales Engagement Specialists and
monitors on-going productivity against targets.
- Coach Sales Engagement Specialists via weekly discussions,
monitoring of delegated and internal sales process as applicable,
and develops plan and activities to grow the membership in
compliance with all federal and state regulations.
- Oversee the delivery of key strategic initiatives and
operational plans of Longevity Health Plan that drive operational
quality improvement, member growth, earnings, and regulatory
- Drive laser focus on improving the quality, affordability, and
experience of health care for all patients as well as a relentless
focus on improving the care delivery experience for providers.
- Participate in quality audits and leads change where
appropriate in the market.
- Ensure that all local staff has received required training and
regularly provides feedback for all individuals supporting
Longevity Health Plan operations.
- In collaboration with the executive leadership team, oversee
the integration and delivery of current product offerings and
supplemental benefit offerings in the market.
- Work with Compliance to provide strategic direction and
tactical guidance to ensure full compliance with federal/state
regulations and contract terms and conditions.
- Understand and facilitate legislation/regulations affecting
Longevity Health Plan in the market.
- In coordination with Compliance, provide business leadership to
all compliance reviews.
- Develop and foster effective collaboration between corporate
and functions managed directly by the market.
- Collaborate with colleagues in operational risk, compliance,
and internal audit to ensure that robust policies and procedures
are maintained and that risks are identified and addressed
- Oversee integration of any acquired local assets. Hires, trains
and mentors local market staff and resources.
- Function as a champion of Compliance and collaborate with
corporate teams to ensure that local staff and providers complete
initial and annual Compliance, Model of Care, HIPAA, and FWA
- Represent Longevity Health Plan both in external in external
forums and develop the Longevity Health Plan brand with regulators,
providers, AHCA, and local healthcare partners
- Performs other related duties as assigned . Education and
- MBA or advanced degree in health care management or other
relevant technical or operations field preferred. Knowledge and
- Minimum of 5-10 years of health care industry experience, with
Medicare expertise required (either through plan or provider
- Strong local market knowledge of the skilled nursing home
environment and experience in Medicare Advantage marketing and
sales strongly preferred.
- Health plan and provider organization management experience is
- Understanding of functional areas and their impact on overall
performance (beyond operations, including clinical, finance, IT,
compliance, and legal).
- Knowledge of the evolving health care delivery system,
including expertise in population health management, Medicare
health plan operations and value-based care delivery models, as
well as a passion for improving the quality and affordability of
health care for the frail and elderly living in nursing homes
- Strong entrepreneurial drive along with the operational skills
needed to consistently drive results.
- Excellent written and oral communication skills with internal
and external business partners and employees.
- Strong, independent decision-maker and calculated
- Strong strategic and analytical orientation with the ability to
drive operational excellence and strong business performance.
- Ability to maintain relentless personal and team focus on
achieving long-term objectives in the face of potential
- Excellent planning and problem-solving skills that enable quick
identification and efficient resolution of issues.
- Highly collaborative with the ability to influence others and
build strong professional relationships, especially in a highly
matrixed organization . Candidates must meet the Company's hiring
criteria which includes a pre-employment background and drug
screening. Longevity Health Plan is an Equal Opportunity Employer.
All qualified applicants will receive consideration for employment
without regard to race, color, religion, gender, national origin,
disability status, protected veteran status or any other
characteristic protected by law. Longevity Health Plan offers a
competitive compensation and benefits package which includes
medical, dental, vision, short and long-term disability, life
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Keywords: Aircall, Tuscaloosa , Market Leader, Other , Greensboro, Alabama
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