Director, Medicare Advantage Administration

Emergent Holdings; United States; Remote; USD 120,000 - 203,000; Full time

Job summary

An established industry player is seeking a Director of Medicare Advantage Administration to partner with leadership in developing and implementing strategies for risk adjustment, quality, and cost initiatives. This role demands exceptional analytical skills, strong communication abilities, and a strategic mindset. The ideal candidate will lead project management efforts while supporting executive functions and driving process improvements. With a focus on operational excellence, this position offers a unique opportunity to make a significant impact in the Medicare Advantage segment. Join a forward-thinking team dedicated to enhancing healthcare outcomes.

Qualifications

• 7+ years of leadership experience in health plans.
• Strong strategic mindset and independent work ability.

Responsibilities

• Collaborate with leadership to develop strategic plans.
• Oversee process improvements and track initiatives.
• Act as a trusted advisor to the Vice President.

Skills

Analytical Skills

Communication Skills

Risk Adjustment Expertise

Quality Improvement Knowledge

Cost of Care Understanding

Education

Bachelor's Degree in Insurance or Related Field

Job description

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Job Description

The Director, Administration acts as a strategic partner to the Vice President, Risk Adjustment, Quality, and Analytics (RQA), supporting the organization's vision, strategy, and operational excellence. The ideal candidate will possess strong analytical skills, exceptional communication abilities, and expertise in Risk Adjustment (RA), Quality (QI), and Cost of Care (CoC) for the Medicare Advantage book of business. Responsibilities include coordinating internal and external resources to meet organizational goals professionally.

Summary

The Director, Administration, partners with the Vice President to develop and implement strategies for the Medicare Advantage segment, supporting risk adjustment, quality, and cost initiatives. The role involves strategic planning, project management, advisory functions, and administrative leadership.

Essential Duties and Responsibilities

1. Strategic Support: Collaborate with leadership to develop strategic plans, support key initiatives, and lead growth levers.
2. Serve as an Advisory/Proxy: Act as a trusted advisor to the Vice President, representing them in meetings and decision-making processes.
3. Project Management: Oversee process improvements, track initiatives, and lead special projects impacting the segment.
4. Administrative Capacity: Support executive functions, coordinate meetings, oversee performance metrics, and assist with budgeting and resource planning.
5. Education and Experience: Minimum 7 years of leadership in health plans, with a bachelor’s degree in insurance or related field.
6. Qualifications: Strategic mindset, independent work ability, technical proficiency, excellent communication, professionalism, and strong analytical skills.
7. Working Conditions: Virtual and field work, travel required, valid driver’s license needed.
8. Compensation: Estimated between $120,900 and $202,500, based on experience and location.

About The Team

COBX Co

Seniority Level:

Director

Employment Type:

Full-time

Job Function:

Management and Manufacturing

Industry:

Insurance