Medicare Strategy & Operations Manager

Univera Healthcare; City of Rochester (NY); Hybrid; USD 79,000 - 142,000; Full time

Job summary

Univera Healthcare seeks a strategic Operations Manager to drive Medicare line of business strategy and execution, ensuring programs align with approved benefit design, regulatory requirements, and strategic objectives. You will manage cross-functional teams and act as a regulatory liaison as needed.

You will collaborate with Marketing, Finance, Compliance and IT to integrate Medicare perspectives into enterprise initiatives, review operational performance, and advocate for process improvements

Qualifications

• Bachelor’s degree in health administration, marketing, business administration or related field.
• Strong leadership and/or management experience.
• Strong regulatory and accreditation knowledge (NCQA, CMS, DOH, State agencies).
• Remain current on regulatory requirements.
• Strong process and program management, analytical and problem-solving skills.
• Project management experience required.
• Must be a critical thinker with negotiation skills at senior levels.
• Self-motivated and able to work independently.
• Proficient in MS Word, Excel and PowerPoint.
• Strong analytical, strategic thinking and communication abilities.

Responsibilities

• Develops strategic, operational, and tactical business plans for Medicare lines of business.
• Evaluates market opportunities and builds business cases.
• Assesses operations to identify root causes of problems affecting compliance and satisfaction.
• Streamlines processes with stakeholders to improve efficiency.
• Leads special projects to support line of business goals and regulatory requirements.
• Encourages innovation and cross-functional collaboration.
• Maintains enterprise relationships to align priorities.
• May serve as regulatory liaison to NYS, CMS, or BCBSA as needed.
• Gathers customer feedback and ensures cross-department alignment.

Skills

Leadership

Regulatory knowledge

Project management

Analytical thinking

Communication skills

Negotiation skills

Self-motivation

Strategic thinking

Cross-functional collaboration

Education

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

Tools

MS Word

Excel

PowerPoint

Job description

Univera Healthcare seeks a strategic Operations Manager to drive Medicare line of business strategy and execution, ensuring programs align with approved benefit design, regulatory requirements, and strategic objectives. You will manage cross-functional teams and act as a regulatory liaison as needed.

You will collaborate with Marketing, Finance, Compliance and IT to integrate Medicare perspectives into enterprise initiatives, review operational performance, and advocate for process improvements