Medicare Strategy & Operations Lead

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

Benefits offered by this job

Remote work options

Job summary

Lifetime Benefit Solutions, Inc. is seeking a Medicare strategy and execution specialist in the United States. The role focuses on assuring benefit design alignment, regulatory compliance, and strategic objectives for the Medicare line of business.

Responsibilities include developing business plans, evaluating market opportunities, addressing operational issues, and coordinating with Marketing, Finance, Compliance, and IT to drive performance and customer satisfaction.

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.
• Strong facilitation skills and follow through. Project management experience required.

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.
• Encourages innovation, process improvements and personal development within the functional business areas that support the Medicare products.
• Develops and maintains relationships across the enterprise to promote consistent strategic priorities.
• May serve as a regulatory liaison to NYS, CMS or BCBSA as needed.
• Collaborates with cross functional business and project teams to ensure alignment to line of business objectives, compliance, operational performance and process improvement.
• Ensures cross functional integration of strategies with key internal areas including, but not limited to Marketing, Operational Excellence, Population Health Engagement, Finance, Provider Contracting, Compliance and Enterprise information Technology.

Skills

Leadership

Regulatory knowledge

Analytical thinking

Negotiation skills

Project management

Education

Bachelor’s degree

Tools

MS Word

Excel

PowerPoint

Job description

Lifetime Benefit Solutions, Inc. is seeking a Medicare strategy and execution specialist in the United States. The role focuses on assuring benefit design alignment, regulatory compliance, and strategic objectives for the Medicare line of business.

Responsibilities include developing business plans, evaluating market opportunities, addressing operational issues, and coordinating with Marketing, Finance, Compliance, and IT to drive performance and customer satisfaction.