Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.

The Vice President, Cost of Care & Population Reporting to the Chief Medical Officer (CMO), serves as the lead interface internally to the other areas of the Company, and externally to strategic partners and key stakeholders to integrate population health fully into strategic planning, governance, and the Company’s mission, goals, and operations.

Responsibilities

•Develops and drives strategic initiatives, provider partnerships, and transactions to support the expansion and enhancement of division and market-level value-based operations.

•Designs and oversees implementation of population health operations and integration strategy that supports and delivers on the Company’s health vision, values, goals, operating, and financial performance.

•Develops and oversees a clinical sales and consultative capability to enable the population health team to effectively support sales initiatives, ongoing employer support and operate at scale. Creates innovative solutions and process enhancements to drive financial, quality, and sales success.

•Provides leadership and strategic direction to integrate operational assets. Serves as the lead interface to the other areas of the Company to integrate population health fully into strategic planning, governance, and operations of the Company.

•Partners with clinical leadership to facilitate and implement market-appropriate roadmaps, tools, and playbooks.

•Identifies and manages strategic partners, mergers and acquisitions and initiatives that advance population health-based growth and performance. Develops a consultative capability to enable the enterprise population health team to be effective at scale. Drives initiatives focused on helping health providers succeed in population health programs.

•Interfaces with, and where appropriate manages vendors to optimize programs and initiatives directed to improve the population health care continuum outcomes as needed.

•Supports and executes initiatives to strengthen member-provider relationships and integrate those relationships into the broader member and group experience.

•Partners with other departments to optimize current account performance, grow new lines of business, and increase membership.

• Bachelor’s degree in business, health care administration, public health, nursing, or related field or equivalent combination of education & experience.

•12 years of experience in cost of care and population health program development and integration, 8 years of which is in a leadership role.

•Registered Nurse with current State of Ohio unrestricted license preferred.

•Comprehensive knowledge of the health insurance industry and processing systems including, medical and drug claim adjudication, membership processes, provider arrangements, and legal requirements.

•Demonstrated in-depth knowledge of health care products and health care funding and the ability to incorporate changes in the industry into actionable recommendations.

•Demonstrated ability to conduct and arrange formal presentations to a wide variety of internal and external audiences.

•Exceptional oral, written, and interpersonal communication skills.

•Strong knowledge of project management and continuous improvement methodologies.

•Ability to interact with all levels of staff, management, and executive leadership.

Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes:

A Great Place to Work:

• Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more.

• On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.

• Discounts at many places in and around town, just for being a Medical Mutual team member.

• The opportunity to earn cash rewards for shopping with our customers.

• Business casual attire, including jeans.

Excellent Benefits and Compensation:

• Employee bonus program. Short- and long-term incentive program.

• 401(k) with company match up to 4% and an additional company contribution.

• Health Savings Account with a company matching contribution.

• Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority.

• Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.

• Company holidays and up to 30 PTO days during the first year of employment with options to carry over unused PTO time.

• After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.

An Investment in You:

• Career development programs and classes.

• Mentoring and coaching to help you advance in your career.

• Tuition reimbursement up to $5,250 per year, the IRS maximum.

• Diverse, inclusive and welcoming culture with Business Resource Groups.

About Medical Mutual:

Medical Mutual’s status as a mutual company means we are owned by our policyholders, not stockholders, so we don’t answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us.

There’s a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.

We’re not just one of the largest health insurance companies based in Ohio, we’re also the longest running. Founded in 1934, we’re proud of our rich history with the communities where we live and work.

At Medical Mutual and its family of companies we celebrate differences and are mutually invested in our employees and our community. We are proud to be an Equal Employment Opportunity and Affirmative Action Employer. Qualified applicants will receive consideration for employment regardless of race, color, religion, sex, sexual orientation, gender perception or identity, national origin, age, marital status, veteran status, or disability status.

We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.

Title: Vice President, Cost of Care & Population Health

Location: OH-Brooklyn

Requisition ID: 2400183