Remote Medicare Advantage Programs Lead

Intermountain Healthcare Inc.; Austin (TX); Remote; USD 82,000 - 127,000; Full time

Benefits offered by this job

AP4P plan

Generous benefits package

Job summary

Intermountain Health, operating Select Health programs, seeks a Medicare Advantage leader to manage end-to-end operations, drive CMS compliance, and oversee enrollment, product development, and member services. You will partner with Compliance, Legal, and Finance to optimize performance and cost management while guiding market-level improvements.

The role emphasizes governance, STAR ratings, and payer-operations expertise, with remote flexibility and travel as needed.

Qualifications

• Bachelor’s degree required; 5+ direct years of Medicare Advantage experience.
• Experience with CMS audits, STAR ratings optimization, or quality initiatives.
• Background in payer operations or value-based care organizations.
• Knowledge of delegated/vendor management models.
• Lean, Six Sigma, or equivalent process improvement certification.

Responsibilities

• Lead and oversee daily market operations of the Medicare Advantage program, ensuring CMS compliance.
• Develop, implement, and optimize operations for enrollment, product development, and member services.
• Ensure readiness for CMS audits, program reviews, and regulatory changes during product cycles.
• Collaborate with Compliance, Legal, Finance to interpret CMS guidance and manage expenses.
• Drive improvements in Star Ratings, member experience, quality measures, and KPIs with leadership.
• Support oversight of vendor performance and contract compliance.
• Work with Finance on budgeting, forecasting, and cost management.
• Foster local market accountability and continuous improvement.
• Support growth initiatives and annual enrollment periods.

Skills

Medicare Ops

Leadership

Project Mgmt

Data analytics

Strategic planning

Communication

Analytical skills

Communication skills

Problem Solving

Education

Bachelor’s degree

Job description

Intermountain Health, operating Select Health programs, seeks a Medicare Advantage leader to manage end-to-end operations, drive CMS compliance, and oversee enrollment, product development, and member services. You will partner with Compliance, Legal, and Finance to optimize performance and cost management while guiding market-level improvements.

The role emphasizes governance, STAR ratings, and payer-operations expertise, with remote flexibility and travel as needed.