Medicare Strategy & Operations Lead

Univera HealthСare; City of Rochester (NY); On-site; USD 79,000 - 142,000; Full time

Job summary

Univera HealthCare in Rochester, NY is seeking a Medicare Operations leader to support strategy and execution across Medicare Advantage, Part D, and related products. You will develop business plans, evaluate market opportunities, ensure regulatory compliance, and collaborate with Marketing, Finance, Provider Contracting, and IT to align activities with Medicare objectives.

The role emphasizes process improvement, data-driven decision making, and maintaining member privacy in line with corporate

Qualifications

• Bachelor's degree in health administration, marketing, business administration or related field.
• Minimum of six years progressive health plan operations experience.
• Strong leadership and/or management experience.
• Experience with regulatory and accreditation agencies (NCQA, CMS, DOH, etc.).
• Strong process and program management, analytical, creativity and initiative.
• Strong facilitation and project management skills; ability to negotiate with management.

Responsibilities

• Develops strategic, operational, and tactical business plans for Medicare lines of business.
• Understands and evaluates new market opportunities with business cases.
• Identifies root causes of operations problems affecting compliance and customer satisfaction.
• Collaborates with teams to streamline system operations and processes.
• Plans and implements projects to support line of business objectives and regulatory requirements.

Skills

Leadership

Project management

Regulatory knowledge

Analytical thinking

Negotiation

Communication

MS Word, Excel, PowerPoint

Education

Bachelor's degree in health administration/marketing/business administration or related field

Tools

MS Word

Excel

PowerPoint

Job description

Univera HealthCare in Rochester, NY is seeking a Medicare Operations leader to support strategy and execution across Medicare Advantage, Part D, and related products. You will develop business plans, evaluate market opportunities, ensure regulatory compliance, and collaborate with Marketing, Finance, Provider Contracting, and IT to align activities with Medicare objectives.

The role emphasizes process improvement, data-driven decision making, and maintaining member privacy in line with corporate