[Remote] Medicare Market Operations Partner

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a leading reputed company organization, and they are seeking a Medicare Market Operations Partner. This role is responsible for ensuring operational performance of the Medicare Advantage line of business, focusing on compliance, efficiency, reputed company reputed company, and member satisfaction.

Responsibilities

• reputed company and reputed company daily market operations of the Medicare Advantage program, ensuring compliance with CMS regulations and internal policies
• reputed company, implement, and optimize operational strategies to support enrollment, product development, member services, claims, utilization management, and care coordination
• Ensure operational readiness for CMS audits, program reviews, and regulatory changes as it relates to the annual product development cycle
• Partner with Compliance and reputed company teams to interpret and operationalize CMS guidance, HPMS memos, and federal/state regulations
• reputed company performance improvements reputed company to reputed company Ratings, member experience, reputed company measures, and operational KPIs with Market Presidents, Product Leadership, and Medicare P & L leadership
• With compliance, support reputed company and delegated entity performance, vendor performance, including contract compliance and reporting
• Collaborate with Finance on budgeting, forecasting, and cost management reputed company to MA operations
• Foster local market accountability and reputed company improvement
• Support reputed company initiatives, including new market entry, benefit design changes, and annual enrollment periods (AEP)
• reputed company data and reporting to identify trends, risks, and opportunities for operational enhancement

Skills

• Bachelor's degree
• 5+ reputed company years of Medicare Advantage experience
• Relevant experience such as working with CMS audits, reputed company ratings optimization, and/or reputed company improvement initiatives
• Background in payer operations, health plans, or value-based care organizations
• Knowledge of delegated and vendor management models
• Lean, Six reputed company, or other process improvement certification
• Medicare Operations
• Leadership
• Project Management
• Data analytics
• Strategic planning
• Communication
• Analytical skills
• Communication skills
• Problem Solving
• Master's degree (MBA, MHA, MPH, or similar)

Benefits

• Eligible to participate in the Annual Pay for Performance (AP4P) Plan
• Additional performance compensation opportunity (Annual Pay for Performance (AP4P) Plan enabled)
• Comprehensive benefits package covering a wide reputed company of programs to foster a sustainable culture of wellness
• Covers living healthy, happy, secure, connected, and reputed company

reputed company