Job Description

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

* Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

* Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

* Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

* Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Skills / Requirements

JOB SUMMARY: The VP of Product and Business Development is responsible for developing and leading the product strategy, and business development initiatives for Community Health Choice.  Provides strategic oversight of all product portfolios and offers for members and that drives significant growth and profitability.  Partners closely with Medical Affairs, Network Management and Finance leaders to ensure the efficacy and financial feasibility of all products. Work collaboratively with operational leadership as well as external partners (hospital systems, Medicare and commercial payers, physician groups and ACOs) to ensure products deliver improved member care and outcomes while reducing cost. Manage the implementation and ongoing synchronization of the STAR+PLUS program, including regulatory review, program launch, and operational processes.  Partner with other members of leadership to shape a strategic product roadmap that allows us to continue to scale our business and impact.

MINIMUM QUALIFICATIONS:

  • .Education/Specialized Training/Licensure: Bachelor¿s degree in Healthcare or Business Administration or related field. Valid State Health and Life Insurance License
  •  Work Experience (Years and Area): 10 years, experience with managed healthcare or healthcare insurance with product or business development experience, preferably in Medicaid   [STAR+PLUS/STAR Kids] and/or Medicare.
  •  Management Experience (Years and Area): 5 years management experience
  •  Software Operated: Microsoft Office (Word, Excel, Outlook)
  •  Other Requirements: Travel around Houston, surrounding counties and Austin, TX


SPECIAL REQUIREMENTS:

  • Communication Skills: Above Average Verbal (Heavy Public Contact), Exceptional Verbal (e.g., Public Speaking), Writing /Composing  (Correspondence  / Reports


Other Skills: 

  • Analytical, MS Word, MS Excel
  • Advanced Education:  Bachelor's degree required
  •  Work Schedule is  Flexible


RESPONSIBLE TO:  COO

EMPLOYEE SUPERVISED: Service

Application Instructions

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