Vice President, General Manager

🔥 11 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $168k - $240k / year

⏰ Full Time

🔴 Lead

👔 Vice President

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Gainwell Technologies

WebsiteLinkedInAll Job Openings

10,000+ employees

💼 Consulting

📦 Logistics

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Consulting • Logistics • Healthcare Insurance

Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

📋 Description

• Drive the vision, strategy, growth, and execution of Gainwell's Medicaid Pharmacy Administration and Technology portfolio • Provide executive leadership and strategic direction for the Medicaid Pharmacy Administration and Technology product portfolio • Lead strategy and execution for enterprise pharmacy solutions including claims processing, POS adjudication, clinical edits, prior authorization, DUR, PDLs, supplemental rebates, PBM capabilities, analytics, and interoperability initiatives • Partner with state Medicaid agencies, executive client leadership, pharmacy directors, CMS stakeholders, clinical teams, and technology organizations • Drive modernization through cloud transformation, automation, API-enabled interoperability, FHIR standards, data analytics, AI-enabled decision support, and scalable product architecture • Direct delivery and implementation of pharmacy administration solutions across multiple Medicaid clients • Serve as executive sponsor for strategic pharmacy initiatives across Product Management, Engineering, Clinical Services, Operations, Sales, Account Management, Implementation, and Government Relations • Manage P&L, investment strategy, revenue growth, margin improvement, pricing strategy, and long-term business planning for the Medicaid Pharmacy product portfolio • Develop business cases for strategic investments, modernization, acquisitions, partnerships, and innovation initiatives; present recommendations to executive leadership and oversee execution • Support new business pursuits, proposal development, executive presentations, solution strategy, and client demonstrations • Build strategic partnerships with pharmacy technology vendors, clinical partners, industry organizations, and strategic alliances • Ensure compliance with Medicaid regulations, CMS guidance, HIPAA, NCPDP standards, drug rebate requirements, pharmacy audit requirements, and contractual obligations

🎯 Requirements

• Twenty or more years of progressive leadership experience in healthcare technology, Medicaid, pharmacy administration, pharmacy benefit management (PBM), healthcare SaaS, or health information systems • Demonstrated executive experience leading Medicaid Pharmacy Administration products, pharmacy claims systems, PBM platforms, pharmacy operations, or state Medicaid pharmacy technology solutions • Deep knowledge of Medicaid pharmacy operations including pharmacy claims adjudication, NCPDP standards, POS processing, rebates, prior authorization, drug utilization review (DUR), preferred drug lists (PDLs), pharmacy provider management, and pharmacy benefit administration • Strong understanding of federal and state Medicaid regulations, CMS guidance, managed care pharmacy, fee-for-service pharmacy programs, and pharmacy program integrity • Experience defining enterprise product strategy, product lifecycle management, roadmap development, commercialization, and technology modernization within highly regulated healthcare environments • Experience leading digital transformation initiatives involving cloud technologies, APIs, interoperability, analytics, automation, and AI-enabled healthcare solutions • Fifteen or more years of executive leadership experience managing large cross-functional organizations • Experience working with Lean, Six Sigma, Agile product development, and continuous improvement methodologies • Experience managing complex P&Ls, investment planning, business case development, pricing strategy, and financial performance for large healthcare technology portfolios • Proven success building executive relationships with state Medicaid agencies, healthcare executives, technology partners, and industry organizations

🏖️ Benefits

• Work flexibility • Learning and career development • Generous, flexible vacation policy • 401(k) employer match • Comprehensive health benefits • Educational assistance • Leadership and technical development academies