Director of Medicare Operations

1 week ago

ValdeReuil, Normandie, United States Elevance Health Full time
Job Title: Director I Medicare Operations

This is a leadership role that oversees the operations of Medicare programs, ensuring compliance with federal regulations and delivering high-quality services to our customers.

Key Responsibilities:
  • Direct multiple business function operations teams on Tier I contract with primary responsibility for Program Management and/or Medicare Integrity Operations.
  • Develop and implement operational strategies to improve efficiency, productivity, and quality of services.
  • Collaborate with cross-functional teams to identify and address operational issues and implement solutions.
  • Ensure compliance with federal laws and regulations, including the Medicare program.
  • Manage the performance of compliance to determine the adequacy of internal controls and identify workflow efficiencies.
  • Drive innovation throughout the assigned business function areas to reduce costs associated with performing CMS statement of Work requirements.
Requirements:
  • BA/BS in a related field and minimum of 7 years professional/leadership experience with CMS, including strategic planning, project management, Medicare or related healthcare insurance or medical policy field.
  • Minimum of 3 years management experience; or any combination of education and experience, which would provide an equivalent background.
  • Strong financial acumen; ability to manage department financials to include annual forecasting, monthly oversight, and ability to adequately convey trends and resolve variances.
  • Ability to develop a 2-3 year operational strategy plan and manage oversight of plans.
  • Frequent and regular contact with various representatives of CMS and peer contractor staff.
  • Ability to meet with customers and deliver polished presentations when needed.
Preferred Skills:
  • Understanding of technology and ability to partner with IT to create a roadmap for enhancements and automation.
  • Experience with managing operational workloads, productivity, and planning forecasts and creating formalized plans to resolve issues.
  • Understanding of the Agile PI Planning Process.
  • Innovation and Change mindset; must have experience managing associates through change.
Location:

District of Columbia (Washington, DC); Maryland; New York.

Benefits:

Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution.

The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company.

The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting.

This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level.

No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans.

The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

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