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Health Plan Market Performance Leader

Remote, Remote · Biotech/Pharmaceutical

Job Description:

The Market Performance Manager for Individual & Family Plans (IFP) is the market-level business owner that is accountable for executing a comprehensive market strategy that builds the business
and develops short/long range goals and business plans in order to deliver targeted growth and earnings. The role will drive change leadership to best align the localization strategy within an evolving IFP business model in order to achieve business results such as profitability and scale. This individual  will build a deep understanding of the marketplace and create an IFP strategy around competitive activity and distribution tactics, cost structure, risk, product and pricing position in the market, and will identify key segment specific needs in order to direct the network and benefit design in order for the business to be competitive and differentiated. The Market Leader will represent the IFP business in their assigned market(s) and develop relationships that support growth, distribution, and partnership strategies.

Core Responsibilities:
  • Develop short and long-term strategic plans for assigned markets which includes the identification of business opportunities to support overall growth plans with an emphasis on
  • developing and growing all channels and increasing market share own and proactively manage P&L for assigned markets with responsibility for delivering on business goals and targeted performance; monitor financial /operational performance (sales volume, retention, risk performance, operational stats, and expense drivers) and work across the business to drive the strategy (product, pricing, etc.) and corrective actions to meet targets.
  • Leads the development of multi-year strategy and annual performance improvement plans Drives growth and performance of assigned market(s).
  • Primary IFP representative to market accountable for building strong local relationships (e.g.regulators, navigators/enrollment assistors, NPOs).
  • Lead expansion into new rating areas within assigned markets (states) to support membership growth as applicable.
  • Develop annual and long-term membership and financial projections in partnership with Finance Brings a strong P&L orientation; identify and drive opportunities in support of maximizing
  • P&L while managing risk
  • Maintain a comprehensive understanding of local market dynamics, competitive landscape,and legislative developments.
  • Partner with marketing, advertising and distribution partners to promote the brand within the local market.
  • Effectively create, manage and maximize key in market relationships to create synergies,
  • alliances and new opportunities in support of market specific goals and strategies.
  • Build collaborative relationships across the enterprise to achieve corporate, financial and market objectives while providing the very best in products and customer service.
  • Maximize IFP value proposition through partnerships with key matrix organizations (network, contracting, medical management, distribution, account management, product,etc.).
  • Partners with internal stakeholders including contracting, distribution, risk management, pricing, product and strategy development to ensure that IFP business needs are delivered across the enterprise, while keeping other areas informed on our key business results and strategies.

Minimum Qualifications:
  • Minimum of a Bachelor's degree in business, healthcare, or related field equivalent experience. (Master’s Degree Preferred)
  • 7 years in a market management, product management or segment strategy role, with at least 3 years in Qualified Health Plan / Individual and Family Plans, Medicaid, or Medicare.
  • 2 years owning and managing P&L in healthcare (IFP preferred). 
  • Demonstrated track record of achieving bottom-line results by managing against well-crafted strategic plans.
  • 2 years market leadership within assigned market(s), strongly preferred in IFP business.
  • Demonstrated experience executing membership / financial forecasting
  • Knowledge of Contracting, Product, Provider Relations and Medical Management such that incumbent can leverage support needed to deliver the right customer solution.
  • Proven ability to analyze competitors' products, distribution systems, administrative and service capabilities as well as marketing plans and strategies.
  • Demonstrates ability to anticipate the market and external influences.
  • Demonstrates personal accountability.
  • Prior experience creating and executing on strategies that drive membership growth and delivery of targeted financial targets
  • A team player with experience building strong relationships both internally and externally, and with a strong sense of self-initiative and desire to succeed. Proven leadership, influencing and negotiation skills in a highly matrixed environment.
  • Demonstrated ability to influence others and utilize resources to accomplish tasks. Has excellent win/win negotiation skills. Must have strong communication, interpersonal and presentation skills.
  • Someone with proven experience creating opportunities to drive and sustain profitable growth. Able to develop and execute an aggressive strategic sales and marketing plan targeted at capitalizing on the existing client base coupled with the ability to execute against the plan.
  • Enterprise thinker with proven ability to influence across a matrix environment. Ability to develop relationships across all levels of the organization, as well as externally.
  • Comfortable dealing with and managing an ever changing, highly competitive industry/environment; communicates optimism and confidence in the future.
  • Strong analytical skills. Has the ability to look at different data elements and formulate a business case.
  • Effective communication skills. Experience and comfort level communicating with individuals at all levels.
  • Able to make sound assumptions and is comfortable working in situations where data is incomplete or limited (problem solving).
  • Entrepreneurial thinking skills with strong customer focus and team orientation
  • Drive and commitment to do what is necessary to get the job done efficiently, thoroughly and professionally.
  • Ability to influence organization to drive business plans and achieve results, including an ability to work with cross functional teams to solve problems.
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