Remote Medicare Advantage Operations Leader

001_BCBSA Blue Cross and Blue Shield Association; Chicago (IL); On-site; USD 120,000 - 180,000; Full time

Benefits offered by this job

Annual bonus

Medical/dental/vision insurance

401(k) matching

Paid time off & holidays

Job summary

Blue Cross Blue Shield Association is seeking an operations leader to manage the FE/P MA EGWP line of business, ensuring compliant, timely product builds and strong cross-functional execution.

You will oversee pre/post-launch operational readiness, monitor KPIs, and drive improvements with FEPOC MA Operations, Compliance, Product, Clinical, and Network teams, delivering member and provider value.

Qualifications

• Deep knowledge of Medicare Advantage, Part D, and CMS regulations.
• Experience leading large cross-functional programs and projects.

Responsibilities

• Manage day-to-day operational work streams supporting MA EGWP and FEPOC operations.
• Ensure regulatory compliance and audit readiness across CMS requirements.
• Drive continuous improvement initiatives and Lean Six Sigma concepts.
• Collaborate with Product, Compliance, Clinical, Network, and IPP teams to ensure sound product builds.

Skills

Medicare Advantage knowledge

Cross-functional collaboration

Regulatory/compliance

Data analysis

Executive communication

Education

BS in Healthcare/Business/Public Health

Tools

Facets

HealthEdge

QNXT

Job description

Blue Cross Blue Shield Association is seeking an operations leader to manage the FE/P MA EGWP line of business, ensuring compliant, timely product builds and strong cross-functional execution.

You will oversee pre/post-launch operational readiness, monitor KPIs, and drive improvements with FEPOC MA Operations, Compliance, Product, Clinical, and Network teams, delivering member and provider value.