Highmark · 2 days ago
SVP Government Business Segment President
Pittsburgh, PA
Full-time
Hybrid
Director/Executive
15+ years expHighmark Inc. is a leading health insurance provider, and they are seeking a Senior Vice President for their Government Business Segment. The successful candidate will lead strategy, growth, and accountability for Highmark Health’s Government Segments, focusing on Medicaid, Medicare, and other government markets.
Health CareHealth InsuranceInsuranceWellness
Responsibilities
Attract, develop, and retain a high-performing leadership team and talent base within the Government Segment. Foster a culture of accountability, innovation, collaboration, and employee engagement, setting the tone for company morale and ensuring succession planning
Provide executive leadership and strategic direction for Highmark's Government Segment, ensuring alignment with the organization's overall mission, vision, and financial objectives. This includes owning full profit and loss (P&L) accountability for the segment, directly leveraging and leading the C2V (Cost to Value) strategy to drive consistent growth, optimize financial performance, and achieve profitability targets
Drive rigorous financial planning, budgeting, forecasting, and performance analysis for the segment. Implement effective cost management strategies while ensuring appropriate resource allocation to achieve financial objectives
Develop and execute comprehensive market development strategies, including annual market plans, to achieve membership, revenue, and quality targets within the government segment. Optimize operational efficiencies and pricing strategies to enhance margin performance and effectively manage competitive pressures
Lead the development, execution, and continuous optimization of the Government Segment's product portfolio. Drive segment specific product innovation, informed by deep market understanding, competitive intelligence, and consumer insights, to develop solutions-oriented products and capabilities that enhance market position, achieve desired financial performance, and improve member experience
Strategically develop STARS/Quality and Risk Adjustment initiatives across the Government Business segment, driving measurable improvements in member health outcomes, optimizing Stars ratings, and ensuring the accuracy and completeness of risk adjustment data to maximize revenue and resource allocation
Serve as a pivotal executive leader within Highmark, actively driving and ensuring effective collaboration with senior leaders across all matrixed organizations and corporate functions throughout the enterprise. This critical leadership establishes integrated strategies, enables seamless execution of initiatives, and optimizes alignment to achieve Highmark's overarching goals
Cultivate and maintain strategic relationships with key external stakeholders, including government agencies (federal and state), regulatory bodies, industry associations, providers, community organizations, and advocacy groups. These relationships will help to advance the segment and markets strategic positioning, interests, and influence policy
Develop and oversee robust sales and distribution strategies for the government segment, encompassing direct-to-consumer channels, broker/consultant networks, FMOs, and other partnerships, to achieve sales goals and optimize market reach
Serve as the primary executive responsible for ensuring all segment operations, products, and strategies are in full compliance with complex legislative, regulatory, and contractual requirements specific to government healthcare programs (e.g., CMS, state Medicaid agencies). Partner closely with Legal and Compliance to proactively address emerging issues and maintain a robust compliance framework
Qualification
Required
Bachelor's degree
15 years of health care management leadership with full P&L accountabilities
7 years of Government Markets Segment Experience
10 years of experience in health insurance senior management
Preferred
Master's Degree
10 years of experience in Medicare/Medicaid
10 years of experience in Sales & Marketing
Company
Highmark
Highmark provides health insurance plans for individuals and businesses.
10001+ employees
H1B Sponsorship
Highmark has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (11)
2024 (7)
2023 (19)
2022 (21)
2021 (18)
2020 (23)
Funding
Current Stage
Late StageTotal Funding
$27.3M2018-04-06Grant· $25M
2014-08-07Grant· $2.3M
Leadership Team
Deborah Rice-Johnson
CEO, Diversified Businesses at Highmark Inc. and Chief Growth Officer
Paul Sikora
CTO Provider Services
Recent News
2025-12-11
Company data provided by crunchbase