Lead Strategist for Medicare Initiatives

2 weeks ago


San Francisco, California, United States ASSOCIATION FOR COMMUNITY AFFILIATED PLANS Full time
Are you ready to utilize your expertise in healthcare leadership to establish a new business segment?

As a key member of the team, you will report directly to the Director of Medicare Product, taking charge of the strategic development and implementation of the Medicare Dual Special Needs Plan (D-SNP) at the Association for Community Affiliated Plans. Your role will encompass ensuring compliance and optimizing operational performance.

In this capacity, you will harness your leadership skills to guide the team in operational strategy, act as a Medicare subject matter expert, and collaborate with operational leaders to recommend enhancements and ensure that the program meets essential compliance and operational benchmarks.

Key Responsibilities:

  • Utilize your Medicare expertise to support the operational framework of the D-SNP and spearhead planning and execution efforts.
  • Facilitate informed decision-making in the development of the Medicare program by sharing industry best practices and leading tactical initiatives.
  • Assist internal stakeholders in crafting and executing both short-term and long-term strategies for the successful launch of the D-SNP product.
  • Serve as an internal subject matter expert, ensuring operational readiness across various functions such as Marketing, Sales, Enrollment, and Risk Adjustment.
  • Collaborate with the Project Management Office to create project plans and readiness timelines for a successful D-SNP launch.
  • Coordinate with Provider Services to ensure compliance with network adequacy standards.
  • Work with Member Services to devise and implement strategies for D-SNP Customer Services and Grievances and Appeals.
  • Develop training materials and internal communications for staff and external partners.
  • Support program development through requirements gathering and business case formulation.
  • Conduct detailed data analysis to inform program strategies.
  • Facilitate knowledge sharing and collaboration among functional teams.

Long-Term Objectives:

  • Enhance program efficiency and service quality by monitoring performance and identifying improvement opportunities.
  • Analyze the dual eligible population and market landscape to uncover new D-SNP product opportunities.
  • Oversee the annual design and application process for the Medicare/D-SNP plan benefit package.
  • Manage the product development lifecycle for applications, bid development, and member materials.
  • Collaborate with Marketing & Communications to ensure compliance in beneficiary communications.
  • Identify operational enhancements to boost efficiency and regulatory compliance.
  • Work closely with cross-functional teams to oversee projects from inception to delivery.

Qualifications:

  • Bachelor's Degree or equivalent experience; Master's degree preferred.
  • Minimum of 10 years in product development, process improvement, or product management, preferably in a Medicare context.
  • At least 3 years of leadership experience.
  • Experience in developing or implementing operational Medicare components for 2 or more years.
  • Knowledge of managed care program regulations, including Medi-Cal and Medicare laws.
  • Proven ability to lead teams and communicate effectively with various stakeholders.
  • Familiarity with healthcare terminology.
  • Strong organizational, time management, and project management skills.
  • Advanced analytical and problem-solving capabilities.
  • Proficiency in MS Office and shared document platforms.

What We Offer:

  • Comprehensive health benefits for you and your dependents.
  • Retirement plans with employer matching.
  • Generous Paid Time Off and holiday schedule.
  • A dynamic work environment with talented professionals dedicated to transforming healthcare.

About Us:
The Association for Community Affiliated Plans is committed to providing affordable healthcare coverage to underserved populations. We pride ourselves on our ability to serve a diverse community and are dedicated to fostering an inclusive workplace.



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