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Vice President & Segment Leader, Individual Market

Vice President & Segment Leader, Individual Market

ASSOCIATION FOR COMMUNITY AFFILIATED PLANSWashington, DC, United States
12 days ago
Job type
  • Full-time
Job description

Overview

The vision of Colorado Access is to have healthy communities transformed by the care that people want at a cost we can all afford. Our mission is to partner with communities and empower people through access to quality, affordable care.

Why should you consider a career with Colorado Access? We are a Colorado-based company, working to improve the health of our state. We care for individuals, families, and children who receive health care under Child Health Plan Plus (CHP+) and Health First Colorado (Colorado’s Medicaid Program). Our focus is driving improvements in quality, member experience, outcomes, and cost. We are a mission-driven organization whose foundation is built by our vision, supported by our values and pillared by diversity, equity and inclusion.

Find work / life balance : We offer PTO, floating holidays, nine company paid holidays, a hybrid work environment, an Employee Assistance Program and a 401K.

Be a part of something bigger and make an impact : We serve the underserved and most vulnerable populations in our community through access to quality and affordable health care. No matter what you do for Colorado Access, you are impacting our community and making a difference.

Sharpen your skills, learn, and grow : We support your continued development through tuition reimbursement, leadership training, promotion opportunities, performance evaluations, employee recognition, and a language pay stipend.

What you will do

We are looking for a VICE PRESIDENT & SEGMENT LEADER, INDIVIDUAL MARKET who can help shape our vision and support our mission. Here is what the position will look like.

Executive Responsibilities

  • In partnership with the CEO and peers, creates, modifies, and implements organization’s vision, mission and strategy.
  • Leads company’s short-term and long-term strategy for financial stability, operational excellence, health transformation and company culture. Communicates, on behalf of the company, with stakeholders, government entities, the public, and employees.
  • Develops business plans and manages resources in alignment with CEO, Board of Directors, and peers to ensure the company reaches its targets and operates efficiently and effectively.
  • Builds high performing teams with vision, leadership, goals and metrics. Serves as a role model for team members; takes action and inspires team members to embrace and implement culture initiatives. Demonstrates a strong work ethic in action and words. Provides awareness to Directors, department leaders and staff how their work impacts other departments, programs and the enterprise. Leads with integrity and ethics and holds self and team members accountable for achieving outstanding results and demonstrating core values.
  • Responsible for all management functions including : hiring, training, planning and directing work, coaching and staff development, managing and evaluating performance, recognizing and rewarding employees, corrective action procedures and practices, addressing complaints and resolving problems. Responsible for approval and management of department budgets and participates in the development of overall company-wide budget.
  • Works closely with Executives and Directors across the organization to make strategic and operational decisions that advance company strategies and goals and collaborates to deliver on company-wide deliverables / requirements.
  • Oversees / leads corporate level projects and continuous improvement initiatives across multiple areas in the organization and / or cross-functional teams.
  • Represents organizational strategy in public forums and with key stakeholders to strengthen and build relationships. Consistent with organizational direction, works to shape policy and potential partnerships to advance strategic priorities.
  • Oversees the development and implementation of multiple department policies and procedures to ensure compliance with federal, state, local and company policies, rules and regulations, and best business practices.

Job-Specific Responsibilities

  • Develop and execute long-term strategy for the Individual Exchange line of business, ensuring alignment with organizational goals.
  • Define and prioritize growth and retention strategies, including market expansion opportunities and optimization of existing markets.
  • Monitor and respond to regulatory, political, and competitive developments affecting the ACA marketplace. Oversee product design, pricing, and portfolio differentiation to maintain competitive positioning.
  • Partner with actuarial and underwriting teams to balance profitability, affordability, and consumer value.
  • Lead implementation readiness for Qualified Health Plan (QHP) market entry, coordinating across internal teams and external vendors.
  • Own the P&L for the Individual Exchange business, managing revenue, medical cost, and administrative expense targets.
  • Monitor and improve Medical Loss Ratio (MLR), risk adjustment performance, and premium revenue.
  • Collaborate with operations, IT, and customer service to ensure efficient, compliant enrollment, billing, and servicing processes.
  • Champion continuous improvement initiatives to streamline operations and enhance the member experience.
  • Ensure all offerings meet CMS and state requirements, delivering on quality, access, and equity expectations.
  • Oversee QHP filings, including SERFF submissions, ensuring accuracy and timeliness.
  • Partner with legal and compliance teams to ensure adherence to marketplace rules, regulatory standards, and reporting obligations.
  • Represent the Individual Exchange segment internally with the Board and executive leadership.
  • Build and maintain strong relationships with federal and state regulators, marketplace administrators, and industry associations.
  • Serve as a public representative of the segment at industry conferences, forums, and regulatory hearings.
  • Drive enrollment growth and retention in partnership with sales and marketing teams.
  • Foster cross-functional collaboration across departments to support successful execution of strategic goals.
  • Perform other duties as assigned by the President and CEO.
  • What you will bring

    Education : Bachelor’s degree required; A combination of education and experience can be substituted in lieu of the degree. MBA, MPH, or related graduate degree strongly preferred.

    Experience : Minimum of 10 years progressive leadership experience in health insurance, with significant expertise in individual ACA / exchange markets. Extensive experience providing and leading in public sector health services with strong knowledge of local systems of care, community organizations and government agencies. Experience launching products in new states or markets. Experience and background working with CMS, State based exchanges, or Medicaid / Medicare Advantage programs highly desired.

    Knowledge, Skills and Abilities : Ability to navigate complex clinical, political, and regulatory environments with sensitivity and cultural competency, especially with populations significantly represented in Colorado Access’s membership and communities. Demonstrated success in managing P&L, developing and executing market strategies and aligning operation decisions with both financial and mission-driven goals. Strong leadership skills, including team development, mentoring, coaching and personnel management. Strategic business planning, change management and project management experience with the ability to manage multiple priorities under tight deadlines. Excellent written and verbal communication skills, including strong public speaking and presentation skills for internal and external audiences. Strong interpersonal and relationship-building skills with the ability to engage key partners, develop partnerships and collaborate across functions and organizations. Analytical mindset with the ability to use data to drive strategic decisions and monitor performance outcomes. Proficiency with digital enrollment and member engagement tools to support growth and member experience. Commitment to Colorado Access’ mission, vision and values and ability to model them in leadership and decision-making.

    Licenses / Certifications : A valid driver’s license and proof of current auto insurance will be required for any position requiring driving.

    Together we will be : an innovative and collaborative team who supports each other, the employees and vision of the company to reach our goals individually, together and as an organization.

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