Fallon Health seeks a dynamic and seasoned executive to serve as its inaugural Senior Vice President, Chief State Programs Officer (SVP). This newly created position will lead Medicaid, One Care expansion, Community Care, and other state programs that will further Fallon Health’s mission to serve individuals who access programs sponsored or supported by the State of Massachusetts. The SVP will execute the strategic plan, care model and focus on performance partnering with state Medicaid officials as well as Fallon team members. The SVP is a crucial position in Fallon Health and requires a mature executive who can work in a nimble, unpretentious culture that has high expectations for leadership. This leader will constantly be seeking ways to optimize service and performance on state programs.

Fallon Health is a leading health care organization that provides care, coverage and services designed to meet the unique and changing needs of the communities they serve. Headquartered in Worcester, Mass., Fallon is both an insurer and provider of care. With a predominant focus on government sponsored plans, Fallon Health’s product portfolio includes a variety of health plan options, which includes Medicaid and Medicare Advantage plans. Fallon also offers a Medicare Advantage Special Needs Plan/Senior Care Options program, called NaviCare. As a provider of care, Fallon offers a Program of All-Inclusive Care for the Elderly, called Summit ElderCare (PACE). Fallon Health is in a strong financial position with a projected revenue of $1.8 billion for 2021, with over 80% of revenue from government programs. Medicaid is roughly one-third of the revenue at approximately $663 million. The organization has a strong balance sheet; high cash investments and reserves are at an all-time high. Fallon Health has approximately 1,200 employees.

The successful SVP candidate will have highly developed people skills and a track record of engaging internal and external stakeholders in a variety of different settings, including provider partners and regulators. This individual must understand managed Medicaid products and ACOs, coupled with a strong knowledge of provider networks and contracting. As an integral member of the executive leadership team, the SVP will report to the President and CEO, Richard Burke. The position includes full P&L responsibility, inclusive of membership, revenue, cost of care, and budgeted operating margin for each product. The Medicaid business is profitable and operationally sound. The SVP will assess the needs of the organization in the State Programs space and build the function and team as necessary. The SVP will be open to compromising, teaming, and working side-by-side with other senior leaders and their teams.

Nominate a colleague, express interest, or apply for this position today via the WittKieffer website here. If you have questions about this opportunity, please contact Tom Quinn via email at tomq@wittkieffer.com.

All inquiries, applications and nominations will be held in the highest confidence.