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2026 Leadership Academy Application

Thank you for your interest in the 2026 ACAP Leadership Academy! Please complete this interest/nomination form by COB on Monday, December 15, 2025.

Please Note: A letter of support from your respective health plan's CEO is requested; please upload the letter to this form OR send the letter directly to Enrique Martinez-Vidal (emartinez-vidal@communityplans.net) and Preeti Juturu (pjuturu@communityplans.net).
1.Member Plan Name(Required.)
2.Name(Required.)
3.Applicant Email(Required.)
4.Applicant Job Title(Required.)
5.Please provide us with a summary of your current and recent professional and work experience.(Required.)
6.Please tell us what you hope to gain from participation in the Academy, including specific topics or issues for which you would like more information or greater perspective (e.g., issues related to Medicaid policy/financing; health plan operations; and/or management/leadership strategies).(Required.)
7.From the list below, please select your area of expertise and/or job oversight. Check all that apply.(Required.)
8.Do you have any additional questions regarding the ACAP Leadership Academy? ACAP staff will email you separately with a response.(Required.)
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