AmeriHealth Caritas, one of the nation’s largest Medicaid insurers, has restructured its leadership team under a new CEO after the company failed 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 employees obtained by the Inquirer. AmeriHealth Caritas is majority owned by Independence Health Group, which also owns Independence Blue Cross.

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

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

“We are excited to advance our leadership team to support our vision of improving 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 the addition of leaders with significant industry experience will strengthen our ability to fulfill our mission of helping people get care, stay healthy and build healthy communities.”

New employees at Centene

Chuck Beeman, a senior vice president at Centene 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 align our organization around clear and predictable operations and member engagement and satisfaction,” Munson’s letter said.

Onboarding on this day is also Gregg McDonald, Centennial Senior Vice President of Markets, responsible for Medicare, Medicaid and Affordable Care Act market operations in multiple states with 4.6 million beneficiaries and $27 billion in revenue. McDonald’s new title at AmeriHealth Caritas is Executive Vice President of Specialty Products and Network.

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

Edith “Edie” Calamia will join AmeriHealth Caritas as chief medical officer late next month, replacing Karen Amstutz, who has held the job for just over three years. Calamia most recently spent a brief stint at Healthcare Partners, a physician group in New York. Before that, she worked at Aetna.

As part of an internal move, Miguel Triana was promoted to Executive Vice President and Growth & Strategy Officer. Triana previously served as Senior Vice President of Strategy and Performance Management.

Departures as AmeriHealth Caritas suffers financial losses

AmeriHealth Caritas had a strong financial year in 2023, with revenue of $23.7 billion and operating income of $348 million, both significant increases over the previous year.

But this year, AmeriHealth Caritas has suffered a number of setbacks. The company lost a bid to remain in Florida, where it has been operating since 2012. The company is protesting against this decision. A bid for Medicaid business in Texas was also rejected. The results of the bid in Georgia, another large state, have not yet been announced.

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

Another development with potential financial implications for AmeriHealth Caritas is that the company will face big-name local competition for a form of Medicaid that funds nursing homes, home health care and other long-term services for low-income seniors and the disabled who are eligible for both Medicare and Medicaid. Health Partners Plans Inc., part of Thomas Jefferson University and the second-largest Medicaid insurer in Philadelphia, will begin competing for that business next year.

In addition to Amstutz, the following executives are leaving:

AmeriHealth will conduct a nationwide search to fill these positions.

“I know this can feel like a big change,” wrote Munson, who ran Aetna’s Medicaid business before taking the AmeriHealth Caritas job. “I am confident that this strengthening of our team and further adjustment of our structure will allow us to focus on key areas and position us to perform better than any other plan in the country.”