Manager, Medicare Operations
Job Location:
St. Louis, MO - USA
Yearly Salary:
Posted:
Application Deadline:
Vacancies:
Job Summary
Were building a world of health around every individual shaping a more connected convenient and compassionate health experience. At CVS Health youll be surrounded by passionate colleagues who care deeply innovate with purpose hold ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger helping to simplify health care one person one family and one community at a time.
This is a hybrid role that requires working 2-3 days a week from the St. Louis Minnesota office.
Position Summary
TheManager of Medicare Operationsis responsible fordesigning and implementing enterprise-wide solutions that address business challenges within ourMedicare organization for Allina Health Aetna. This role is pivotal in shaping organizational strategy ensuring compliance and enhancing operational effectiveness tomaintainour competitive edge in the marketplace. The ideal candidate will partner with business owners to achieve strategicobjectives including profitable growth and improved service delivery.
Whatyouwilldo
- Overseesday-to-dayoperationsoftheorganizationsMedicare programtosupportoperational excellence market readiness and member retention.
Supportsmarketteambydevelopingandexecutingoncross-enterprise initiatives thatensure efficient and effective delivery of services.
Conductsquality assurance reviews to ensure year-over-year updates and accuracyin Medicare member materials and resources.
Assesses the development of government program opportunitiesdevelopsstrategies presentsrecommendationsandimplementssolutionstoimproveoveralllineofbusinessperformance.
Works closely with thelocalaccountmanagementandsalesteamsongrowthand retention strategies.
Supportsthe investigation and remediation of operational issues as they arise serving asthe liaison between the market team and national partners.
Defines& drives process improvement and operationalprojectsincollaborationwithsenior management stakeholders and senior individual contributors.
Manage year-over-year AEP readiness activities including support for product and vendor implementations benefit and material reviews and markettrainings.
Support the annual Medicare bid filing by conducting required analysisconsolidatingcompetitive information and helping to manage bid tools.
Establish andmonitorkey performance indicators (KPIs) to evaluate the success of programs and initiatives.
Requirements:
- Must reside within commutable distance from the St. Louis MN office.
- 3-5 years of experience in health insurance Medicare or a related government-sponsored healthcare program.
- 2 years of project management program management or operational leadership experience.
- Demonstrated experience leading cross-functional initiatives and influencing stakeholders without direct authority.
- Strong analytical and problem-solving skills with the ability toleveragedata to drive business decisions.
- Proven ability to plan execute and deliver complex projects and operational initiatives.
- Excellent written verbal and presentation communication skills.
- Advancedproficiencyin Microsoft Excel and Microsoft Office applications.
Preferred Qualifications
- Medicare Advantage operational experience.
- Experience supporting AEP readinessMedicarebid development or regulatory compliance activities.
- Project Management Professional (PMP) certification or equivalent project management training.
- Experience using Quickbase or similar workflow/project management platforms.
- Experience working with sales account management and market leadership teams to support growth and retention initiatives.
Education
- BachelorsdegreepreferredinBusiness Healthcare administration publichealthor related field.
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$66330.00 - $145860.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience education geography and other relevant factors. This position is eligible for a CVS Health bonus commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers patients members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal state and local laws.
Required Experience:
Manager
About Company
At CVS Health, we share a clear purpose: helping people on their path to better health. Through our health services, plans and community pharmacists, we’re pioneering a bold new approach to total health. Making quality care more affordable, accessible, simple and seamless, to not only ... View more
