Medicare Strategy and Operations Manager

Lifetime Benefit Solutions, Inc.; Town of De Witt (NY); On-site; USD 79,000 - 142,000; Full time

Job summary

Lifetime Benefit Solutions, Inc. is seeking a strategic operational leader to support Medicare line of business strategy and execution.

You will ensure all Medicare products and programs align with approved benefit design, regulatory requirements, and corporate objectives, covering Medicare Advantage, Part D, and Dual Eligible products. You will develop business plans, evaluate market opportunities, and drive process improvements across Marketing, Compliance, Finance, and IT to enhance customer

Qualifications

• Bachelor’s degree in health administration, marketing, business administration or related field with a minimum of six years progressive health plan operations experience.
• Strong leadership and/or management experience.
• Strong expertise and background dealing with regulatory and accreditation agencies such as NCQA, CMS, Federal & State agencies including DOH, Dept. of Finance Services.
• Remain current on all relevant regulatory requirements.
• Strong process and program management skills, analytical, creativity and initiative in problem solving and solution identification.

Responsibilities

• Develops strategic, operational, and tactical business plans to achieve desired business goals for the Medicare lines of business.
• Understands and evaluates new market opportunities, including building of necessary business cases.
• Conducts evaluation, review, and assessment of various operations for the purpose of identifying root causes of operations problems that contribute to noncompliance and customer dissatisfaction.
• Consults with team members and stakeholders to streamline system operations and processes to improve business effectiveness and efficiency.
• Plans, develops, and implements special projects, initiatives, and activities to support line of business objectives, product, benefit administration, regulatory requirements, process improvement, efficiency, and the customer experience.

Skills

Leadership experience

Regulatory expertise

Process management

Project management

Analytical ability

Strategic thinking

Communication skills

Negotiation skills

Self-motivated

Cross-divisional relationships

Education

Bachelor’s degree in health administration or related field

Tools

MS Word

Excel

PowerPoint

Job description

Lifetime Benefit Solutions, Inc. is seeking a strategic operational leader to support Medicare line of business strategy and execution.

You will ensure all Medicare products and programs align with approved benefit design, regulatory requirements, and corporate objectives, covering Medicare Advantage, Part D, and Dual Eligible products. You will develop business plans, evaluate market opportunities, and drive process improvements across Marketing, Compliance, Finance, and IT to enhance customer