New AmeriHealth Caritas CEO Kelly Munson is revamping management at the Medicaid insurer

AmeriHealth Caritas, one of the nation’s largest Medicaid insurers, has revamped its top management under a new CEO and after failures to win new state Medicaid contracts this year.

Kelly Munson, who became CEO of AmeriHealth Caritas in February, announced the sweeping changes to her management team Tuesday in a letter to staff that was obtained by The Inquirer. AmeriHealth Caritas is majority-owned by Independence Health Group, which includes Independence Blue Cross.

The Medicaid-managed care company’s general counsel, chief medical officer, and chief development officer are departing this week. Its chief financial officer, who’s been at the company for less than three years, will retire at the end of the year, Munson said.

Munson also announced the appointment of two veteran executives from Centene Corp., the nation’s largest Medicaid insurer, to top positions.

“We are excited to evolve our leadership team in support of our vision to improve health outcomes and health equity for the populations we serve,” AmeriHealth Caritas said in a statement. “We are confident that the changes to our structure and addition of senior leaders with significant industry experience will strengthen our ability to deliver on our mission to help people get care, stay well, and build healthy communities.”

Chuck Beeman, a Centene senior vice president who oversaw 32 markets with 20 million Medicaid beneficiaries, will start next Tuesday as chief operating officer for business enablement. His job will be to “better focus our company on crisp and predictable operations and member engagement and satisfaction,” Munson’s letter said.

Also onboarding that day is Gregg McDonald, who was Centene’s senior vice president of markets, overseeing Medicare, Medicaid, and Affordable Care Act marketplace businesses in several states with 4.6 million beneficiaries and $27 billion in revenue. McDonald’s new title at AmeriHealth Caritas is executive vice president for specialty products and network.

Headquartered in Newtown Square, AmeriHealth Caritas’ specialized services include Medicare plans, individual plans sold on the ACA marketplaces, behavioral health insurance, and pharmacy benefit management. “We have discussed the importance of growing our specialty products businesses to diversify our portfolio,” Munson’s letter said.

Edith “Edie” Calamia will join AmeriHealth Caritas late next month as chief medical officer, replacing Karen Amstutz, who had been in that job for a little more than three years. Calamia was most recently with Healthcare Partners, a physicians group in New York, for a short period of time. Before that, she was with Aetna.

In an internal move, Miguel Triana has been promoted to executive vice president and growth & strategy officer. Triana had been senior vice president for strategy and performance management.

AmeriHealth Caritas had a strong 2023 financially, with $23.7 billion in revenue and $348 million in operating income, both up strongly from the year before.

But this year, AmeriHealth Caritas has taken some hits. It lost a bid to remain in Florida, where it has been in business since 2012. It is protesting that loss. It also lost a bid for Medicaid business in Texas. The results of bidding in Georgia, another large state, haven’t been announced.

The company, which employs about 9,800 people, laid off 102 employees last month, including 13 at its Delaware County headquarters, citing the nationwide decrease in membership that is affecting all plans.

In another development with potential financial consequences for AmeriHealth Caritas, the company will have well-known local competition for a form of Medicaid that pays for nursing homes, home care, and other long-term services for low-income seniors and disabled people who qualify for both Medicare and Medicaid. Health Partners Plans Inc., part of Thomas Jefferson University and the second-largest Medicaid insurer in Philadelphia, will start competing for that business next year.

In addition to Amstutz, the departing executives are:

AmeriHealth will conduct a national search to fill those positions.

“I know this may feel like a lot of change,” wrote Munson, who led Aetna’s Medicaid business before taking the job at AmeriHealth Caritas. “I am confident that these additions to our team and further alignment of our structure will allow for dedicated focus on key areas and set us up to execute better than any other plan in the country.”