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President and CEO
Trinity Health. Provide leadership, direction, and management to MediGold’s Medicare Advantage HMO and health insurance products .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates extensive leadership in managing Medicare Advantage HMO and health insurance products, with a strong focus on strategic direction, operational execution, and compliance with state and federal regulations. Proven ability to drive quality outcomes, financial performance, and community engagement through effective partnerships and innovative strategies.
Highest-signal resume keywords
Medicare Advantage ExperienceExecutive-Level LeadershipFinancial ManagementRisk ManagementStrategic Planning
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Health Plan ManagementOperations OversightBudget DevelopmentBusiness Process OutsourcingQuality ImprovementRevenue Growth StrategiesMatrix ManagementRegulatory ComplianceData AnalysisPerformance Monitoring
Soft Skills
Effective CommunicationStrong Business AcumenIntegrityAdaptabilityTeam Leadership
Tools & Technologies
Information SystemsArtificial IntelligencePayment Integrity Systems
Industry Keywords
Medicare AdvantageIntegrated Delivery SystemHealth InsuranceCommunity EngagementProvider Partnerships
About the role
Key responsibilities & impact- Provide leadership, direction, and management to MediGold’s Medicare Advantage HMO and health insurance products
- Lead strategy, medical delivery network, Medicare bid development, government programs, risk adjustment, operations, sales and marketing, medical management, quality, finance, actuarial, and shared legal, IT, and compliance responsibilities
- Report to the Trinity Health EVP and Chief Operating Officer accountable for MediGold
- Develop and recommend strategies for county expansions, bid development, annual AEP marketing strategy, and overall strategic direction
- Develop and execute MediGold’s strategic direction
- Translate the strategic plan into operational actions and results through culture, people, processes, and technology
- Implement policies, plans, and operating practices approved by the Plan Board of Directors and required by regulations
- Recruit, develop, support, and direct Plan staff
- Build and develop an engaged leadership team aligned with Mount Carmel Health and Trinity Health values
- Develop and administer operational and capital budgets
- Develop and oversee annual and long-range plans
- Maintain relationships with community groups, provider agencies, regulatory bodies, governmental agencies, and industry stakeholders
- Monitor performance against risk-based arrangements and create provider incentives based on outcomes
- Advance clinical and financial integration with Trinity Health Clinically Integrated Networks and medical groups
- Direct Marketing, Finance, Health Services, and Operations
- Prepare business status reports and recommendations for the Plan Board and regulatory agencies
- Maintain high-quality care, member services, and employee satisfaction
- Oversee information systems and Business Process Outsourcing contracts, payment integrity, technology strategy, and appropriate use of artificial intelligence
- Develop infrastructure for growth and expansion
- Partner with regional health ministry executives and Trinity Health leaders
- Drive quality outcomes measured by STAR ratings
- Represent MediGold and Mount Carmel in community organizations and activities
- Develop partnerships with health systems and physician organizations participating in risk contracts
- Develop annual financial plans for profitable growth
- Ensure compliance with state and federal regulations
- Promote a culture of safety
- Build relationships outside the immediate service area to support outlying partner providers
- Champion MediGold and its provider partners in the communities served
Requirements
What you’ll need- Bachelor’s degree required; Master’s preferred
- At least ten (10) years of experience in a leadership role in a relevant health plan with progressively increasing responsibilities
- Executive-level leadership in management of a health plan
- Experience overseeing the growth, operations, and financial results of a health plan
- Experience working in a health plan that is part of an integrated delivery system preferred
- Track record in increasing revenue and profits
- Experience in matrix management
- Significant Medicare Advantage experience
- Effective communication skills
- Strong business acumen
- Unquestionable integrity
- Experience managing risk partners (at-risk provider groups)
- Ability to adapt to frequently changing work priorities
- Ability to travel as needed to various Trinity Health sites
Benefits
Comp & perks- Equal Opportunity Employer
- Mission- and values-driven work environment
- Opportunity to lead a Medicare Advantage organization within an integrated health system
- Travel to various Trinity Health sites as needed