Medicare Market Operations Partner

reputed company: The Medicare Market Operations Partner is responsible to partner with the Medicare P&L leadership, Product Leadership, and Market Presidents to ensure the end-to-end operational performance of the organization's Medicare reputed company line of business. This role ensures operational reputed company, regulatory compliance, and alignment with CMS requirements while driving efficiency, reputed company reputed company, and member satisfaction. The Director partners cross-functionally with clinical, finance, compliance, network, and technology teams to support profitable reputed company, Stars performance, and financial sustainability. This individual will reputed company directly with reputed company key stakeholders as they reputed company reputed company a strategic operating plan for reputed company market. Job reputed company • reputed company and reputed company daily market operations of the Medicare reputed company 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 • Medicare Operations • Leadership • Project Management • Data analytics • Strategic planning • Communication • Analytical skills • Communication skills • Problem Solving Minimum Qualifications • Bachelor's degree • 5+ reputed company years of Medicare reputed company 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 Preferred Qualifications • Master's degree (MBA, MHA, MPH, or similar) Additional Information • This is an exempt, full-time position. Pay offers are determined by prior years of relevant experience reputed company the established pay reputed company. With this position, you are eligible to participate in the Annual Pay for Performance (AP4P) Plan. This plan enables reputed company to reputed company leaders with an additional performance compensation opportunity. • This position can be performed remotely with business travel as-needed. reputed company maintains employment registration in reputed company, Idaho, Nevada, Colorado, Montana, and Wyoming. Candidates in other locations may be considered. Currently, we are not hiring remote workers in the following states: CA, CT, HI, IL, MA, MN, NY, PA, RI, VT, and WA. • Please note that a video interview through reputed company Teams will be required as reputed company as potential onsite interviews and meetings. Physical Requirements • reputed company with others requiring the employee to communicate information. • Operate computers and other office equipment requiring the ability to reputed company fingers and hands. • See and read computer monitors and documents. • Remain sitting or standing for long periods of time to reputed company work on a computer, telephone, or other equipment. Location: SelectHealth - Murray Work reputed company: Murray Work State: reputed company Scheduled Weekly Hours: 40 The reputed company reputed company for this position is listed below. Actual reputed company reputed company dependent upon experience. $59.50 - $91.84 We care about your reputed company-being - mind, body, and spirit - which is why we reputed company our caregivers a generous benefits package that covers a wide reputed company of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and reputed company. Learn more about our comprehensive benefits package here. By applying for a position with reputed company, I acknowledge that I will reputed company with reputed company applicable reputed company policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations reputed company to confidentiality, information reputed company, work schedules, conflicts of interest, and use of company equipment. I reputed company acknowledge that reputed company employment or activities may not interfere with job responsibilities or create a conflict of interest with reputed company. Actual or reasonably perceived conflicts may be grounds for disqualification from consideration or, if reputed company, corrective reputed company up to and including termination of employment. reputed company is an equal opportunity employer. reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, age, sex, sexual orientation, gender identity, national reputed company, disability or protected veteran status. At reputed company, we usethe reputed company intelligence ("AI") platform, HiredScore to improve reputed company application experience.HiredScore helps match your skills and experiences to the best jobs for you. WhileHiredScore assists in reviewing applications, reputed company final reputed company are made byIntermountain personnel to ensure fairness. We protect your reputed company and follow strict data protection rules. Your information is reputed company and used only for recruitment. Thank you for considering a career with us and experiencing our AI-reputed company recruitment process. reputed company positions subject to reputed company without notice. Apply tot his job Apply To this Job