VP,General Manager; OC) Job Orange area,California USA,Business

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve.

In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

General Duties/Responsibilities

Market Business Planning and P&L Execution

Lead the annual Orange County Medicare Advantage business plan, aligning market commitments with enterprise strategy and the Market President's direction.
Translate P&L targets into initiatives, owners, milestones, forecasts, and measurable deliverables.
Own daily execution of approved plans for revenue, medical expense, MLR, membership, quality, risk adjustment, and provider economics.
Develop business plans by major provider, hospital, geography, product, and membership segment.
Maintain a market scorecard against budget, forecast, prior year, and targets; lead monthly reviews and corrective action.
Escalate material financial, regulatory, contractual, and execution risks with recommended recovery plans.
Primary performance commitment:
Deliver approved financial results and an MLR of 87% or less.

RACI Governance and Execution

Establish a formal RACI for each Orange County market initiative with one Accountable decision owner, Responsible execution owners, and Consulted/Informed stakeholders.
Act as the Responsible executive for coordinating integrated execution across Sales, Product, Network, Contracting, Finance, Actuarial, Clinical, Quality, Risk Adjustment, Pharmacy, Operations, Member Experience, and Compliance.
Maintain initiative roadmaps with resources, dependencies, deadlines, financial impact, and clear deliverables.
Conduct weekly execution, monthly performance, and quarterly strategic reviews.
Hold local and functional leaders to documented commitments; resolve barriers within delegated authority and escalation of unresolved issues.
Drive recovery plans rather than serving only as an advisor or meeting participant.

Membership Growth, Retention and Market Development

Lead local growth and retention execution in collaboration with Sales, Product, Marketing, Broker Distribution, and provider leadership.
Set growth objectives by product, provider, channel, geography, and member segment.
Identify market share opportunities, provider partnerships, and product differentiation.
Align network capacity, access, service, and member experience with enrollment and retention.
Monitor enrollment, disenrollment, retention, and competitor trends; initiate recovery plans where needed.
Ensure provider-related marketing and referral initiatives comply with CMS requirements.
Primary performance commitment:
Deliver approved net growth, retention, revenue, and market share targets.

STARS, Quality and Member Outcomes

Own local execution of approved STARS and quality plans in partnership with enterprise Quality, Clinical, Pharmacy, Operations, and providers.
Build provider-specific objectives for HEDIS, CAHPS, HOS, medication adherence, preventive care, and applicable measures.
Coordinate internal clinicians and external provider groups to close care gaps and improve member outcomes.
Embed quality scorecards, corrective actions, and compliant incentives in provider operating reviews.
Monitor performance by provider, contract, product, and market and address underperformance.
Primary performance commitment:
Deliver…

VP, General Manager; OC)