Medicare Strategy & Operations Manager

Excellus BCBS; City of Binghamton (NY); Hybrid; USD 79,000 - 142,000; Full time

Job summary

Excellus BCBS is seeking a senior professional to support Medicare line of business strategy and execution. You will assure that all Medicare products and programs are administered according to approved benefit design, regulatory requirements, and strategic objectives.

You will gain deep knowledge of Medicare Advantage, Medicare Supplement, Part D, and Dual Eligible products. The role requires strong leadership, regulatory acumen, and the ability to coordinate across departments to drive

Qualifications

• Bachelor's degree in health administration, marketing, business administration or related field required.
• Minimum six years progressive health plan operations experience.
• Strong leadership and/or management experience.
• Experience with regulatory and accreditation agencies (NCQA, CMS, DOH, etc.).
• Strong problem solving, project management and communication skills.

Responsibilities

• Develops strategic, operational, and tactical business plans to achieve Medicare business goals.
• Understand and evaluate new market opportunities and build business cases.
• Ensure compliance with regulatory requirements and benefit design across programs.
• Collaborates with cross-functional teams to align strategies and improve customer experience.
• Interacts with regulatory bodies and internal stakeholders to support initiatives.
• Maintains relationships across the enterprise to promote consistent strategic priorities.

Skills

Leadership

Regulatory knowledge

Strategic thinking

Problem solving

Communication skills

Project management

Education

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

Tools

MS Word

Excel

PowerPoint

Job description

Excellus BCBS is seeking a senior professional to support Medicare line of business strategy and execution. You will assure that all Medicare products and programs are administered according to approved benefit design, regulatory requirements, and strategic objectives.

You will gain deep knowledge of Medicare Advantage, Medicare Supplement, Part D, and Dual Eligible products. The role requires strong leadership, regulatory acumen, and the ability to coordinate across departments to drive