Medicare Strategy & Operations Leader

Excellus BlueCross BlueShield; Town of De Witt (NY); Hybrid; USD 79,000 - 142,000; Full time

Job summary

Excellus BlueCross BlueShield seeks a seasoned professional to support Medicare strategy execution and ensure products meet regulatory requirements. You will oversee operational performance, engage with cross-functional teams, and drive initiatives across Medicare Advantage, Supplement, Part D, and Dual Eligible programs.

The role requires strong leadership, regulatory expertise, and the ability to manage complex projects in a dynamic healthcare environment.

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 in regulatory and accreditation agencies such as NCQA, CMS, and state DOH.
• Strong process and program management skills with analytical, creative problem solving.

Responsibilities

• Develops strategic, operational, and tactical business plans to achieve Medicare goals.
• Evaluates market opportunities and builds business cases.
• Interprets regulations and liaises with NYS, CMS, or BCBSA as needed.
• Collaborates with cross-functional teams to align strategies across departments.

Skills

Leadership

Regulatory compliance

Project management

Analytical thinking

Communication skills

Strategic planning

Education

Bachelor’s degree in health administration or related field

Tools

MS Word

Excel

PowerPoint

Job description

Excellus BlueCross BlueShield seeks a seasoned professional to support Medicare strategy execution and ensure products meet regulatory requirements. You will oversee operational performance, engage with cross-functional teams, and drive initiatives across Medicare Advantage, Supplement, Part D, and Dual Eligible programs.

The role requires strong leadership, regulatory expertise, and the ability to manage complex projects in a dynamic healthcare environment.