Name: Jean Rush
Title: Executive VP, Government Markets
How long have you worked for the Highmark Health Family?
I joined Highmark In July 2015 to lead the newly created Government Markets organization as executive vice president.
What is your position here at Highmark and what do you do?
My role is to create and lead our new Government Markets organization which encompasses our Medicare, Medicaid, ACA Individual, and Small Group businesses. These four businesses account for 58% of the revenue here at Highmark and represent some of the fastest growing segments in the healthcare industry. From the aging of the baby boomers to the passage of the Affordable Care Act and recent Medicaid expansion, the past several years have seen tremendous growth in the government space and while it is too soon to predict the changes that may occur following our next presidential election, I think it’s safe to say that government sponsored healthcare will continue to play a critical role in our country’s future.
Here at Highmark I’m leveraging over fifteen years of leadership in government markets to help us transform the way we manage this business so that we can have sustainable and successful products in this critical business segment. This encompasses every aspect of the business including rate setting, product design, network strategy, sales, marketing, compliance, care management, and medical cost management, all of which are important for succeeding in the government markets arena.
A critical component of our strategy is to ensure that we are providing the right types of care management for our members. The needs of our government markets members are often very different from our commercial populations since we are dealing with more complex medical conditions and members who often have numerous chronic conditions. So we have built a new care management model which takes these complex needs into account and which creates a holistic, integrated solution to meet those needs. In this new model, our members work with a team of professionals including nurses, pharmacists, social workers, and behavioral health specialists in order to ensure that we are coordinating all their needs in one comprehensive plan. This could include connecting them to local support services, arranging transportation, or providing nutritional counseling in addition to the more traditional types of medical management. Our goal with the new care management program is to improve the quality of health outcomes while also reducing the overall cost of care by keeping our members healthy!
What did you do before working at Highmark?
I spent 30 years working for Cigna in a variety of roles, first on the financial services side of the business. In the late 90’s, I moved over to the healthcare division where I ran Cigna’s Employer and Provider organization which provided services to all 31,000 Employer customers across the country and which supported our network of over 600,000 providers in 40 healthplans. After that, I became President of Cigna Government Services, a wholly owned subsidiary that focused exclusively on Medicare …and that’s where my passion for working with the vulnerable populations served in government markets began! After leaving Cigna, I moved to Centene where I ran six healthplans all focused on Medicaid, Medicare, and ACA Exchange populations. I also headed up their Complex Care product portfolio which included Medicare, Duals (members who are both Medicare and Medicaid eligible) and LTSS (Long Term Support Services) for members in Nursing Homes, Assisted Living Facilities, and Home/Community Based Services. All of these roles solidified my focus on serving the underserved in our communities.
How do you demonstrate that you have courage, and that you care, and that you collaborate with others in your current role?
By advocating for our members – the little things, like making sure they have transportation. For example, if a member lives in an area with limited or no access to a food store or market, and doesn’t have a car to get to the grocery store, they are more than likely buying their food at a convenience store. And let’s say that member has diabetes – we can talk to them until we are blue in the face about managing their disease, but until we help get them access to nutritious food, it’s hard to address those underlining issues.
Anything else you want to share?
I enjoy golfing, hiking, biking, doing aerobics and traveling. I’ve traveled all over the world, but my favorite place to visit is Italy!