Medicare Strategy & Operations Leader (Remote)

Lifetime Workforce Solutions, LLC; City of Rochester (NY); Híbrido; USD 79.000 - 142.000; Jornada completa

Descripción de la vacante

Excellus BCBS in Rochester, NY seeks a Senior Manager to support Medicare line of business strategy and execution, ensuring programs comply with benefit design and regulatory requirements across Medicare Advantage, Part D, and Dual Eligible products.

You will lead cross-functional initiatives, evaluate market opportunities, drive process improvements, and coordinate with Marketing, Compliance, Finance, and IT to align objectives. Remote work may be possible on a case-by-case basis.

Formación

• Bachelor's degree with six years health plan operations experience.
• Strong leadership and/or management experience.
• Regulatory and accreditation agency knowledge (NCQA, CMS, DOH, etc).
• Regulatory requirements current.
• Project management experience.
• Strong communication and negotiation skills.
• Self-motivated and able to work independently.
• Strong computer skills: Word, Excel, PowerPoint.
• Analytical, strategic thinking and creativity.

Responsabilidades

• Develops strategic, operational, and tactical plans for Medicare lines.
• Evaluate new market opportunities and build business cases.
• Assess operations to identify root causes of issues.
• Streamline operations with stakeholders to improve efficiency.
• Plan and implement projects to support objectives.
• Encourage innovation and process improvements.
• Maintain relationships across the enterprise to align priorities.
• May serve as regulatory liaison to NYS, CMS or BCBSA.
• Collaborate across departments to ensure alignment to objectives.
• Represent Medicare on cross-functional committees.
• Manage delivery of business process work items.
• Stay current on evolving Medicare market dynamics.
• Maintain member privacy compliance.
• Attend regularly and perform other duties.

Conocimientos

Leadership

Regulatory knowledge

Strategic thinking

Project management

Negotiation

Communication

Independence

Educación

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

Herramientas

MS Word

Excel

PowerPoint

Descripción del empleo

Excellus BCBS in Rochester, NY seeks a Senior Manager to support Medicare line of business strategy and execution, ensuring programs comply with benefit design and regulatory requirements across Medicare Advantage, Part D, and Dual Eligible products.

You will lead cross-functional initiatives, evaluate market opportunities, drive process improvements, and coordinate with Marketing, Compliance, Finance, and IT to align objectives. Remote work may be possible on a case-by-case basis.