This HMO Can Be Fixed: New CEO

Apr 16, 2014

Florida Healthcare Plus, a financially struggling Medicare Advantage plan, has brought in a new CEO who's an experienced senior-products executive and turnaround artist.

Susan Rawlings Molina
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Susan Rawlings Molina, who arrived at the Coral Gables-based company in January, says she was recruited for the task by her predecessor, Ray Quirantes. Although the company has been losing money, she told Health News Florida Tuesday afternoon, its investors have provided adequate capital and want to make it a success.

"I was brought in because A) I know how to fix problems, and B) I like to grow businesses," Molina said. "We have work to do to straighten out our issues, paying bills on time, being overstaffed. 

"We know what we need to do," she added. "We're very confident in our future."

As Health News Florida reported Tuesday, Florida Healthcare Plus drew a federal fine of just over $40,000 this month for failing to notify its 8,200 members by the deadline, Sept. 30, of changes in the plan for 2014.

The Centers for Medicare and Medicaid Services set that deadline so that beneficiaries would have time to study their options before open enrollment, which was held Oct. 15-Dec. 7.  Florida Healthcare Plus didn't send the letters out until late October and early  November.

Molina said the company paid the fine without protest. "We understand we made a mistake and we won't make it again," she said, including herself in the mea culpa even though it happened before her arrival.

To pare down administrative costs, the company laid off staff and closed offices in Jacksonville, West Palm Beach and Orlando. It also pared back in Tampa, consolidating authority at headquarters. 

Molina has been in the senior-products side of health insurance for about 25 years, most of it in Texas. A Businessweek bio says she held high-level regional positions for many large players including Aetna, Amerigroup, and PacifiCare, and then served as WellPoint's president of senior services and later,  a senior vice president.

Molina ran Leprechaun LLC, a Fort Worth consulting company for Medicare Advantage plans, from 2008 until 2011, when she became CEO and president of American Health Medicare, a subsidiary of Triple-S Management Corp. in San Juan, which holds the Blue Cross and Blue Shield license in Puerto Rico.

She left Triple S in September and was planning to take time off, she said. But the offer to come work in the Miami area appealed to her. "I like working in the Medicare Advantage business, making sure the doctors get what they need and the members get what they need," she said.