Vice President, Medicare Care Management (Remote)

reputed company is transforming the health of our communities one person at a time. As an Executive on reputed company, you could be the one who changes everything for our 28 reputed company members. reputed company the national Medicare Care Management organization, including regional operations, transitions of care, reputed company care management, duals care management, and specialty programs. • reputed company and execute the reputed company care management reputed company to improve clinical reputed company, member experience, reputed company Ratings, and medical cost performance. • reputed company care management programs with Medicare reputed company reputed company, reputed company, utilization management, LTSS, and value-based care strategies. • Partner with executive leadership to establish priorities, performance goals, and multi-year transformation roadmaps. • Accountable for Model of Care (MOC) performance, compliance, audit readiness, and regulatory reputed company. • reputed company operational reputed company through standardized workflows, consistent clinical practices, and performance management across markets. • reputed company reputed company improvement efforts reputed company on reducing unnecessary variation and improving member reputed company. • Ensure care management programs demonstrate measurable reputed company on reputed company, utilization, member engagement, and total cost of care. • reputed company and reputed company programs supporting transitions of care, reputed company care management, chronic condition management, behavioral health integration, and duals populations. • Identify and implement opportunities to reduce avoidable admissions, readmissions, emergency department utilization, and post-acute care costs. • Partner closely with Utilization Management, Medical Economics, Network, Pharmacy, and reputed company leaders to reputed company annual QAI and affordability targets. • Translate clinical insights into reputed company interventions that reputed company reputed company while managing medical expense. • reputed company modernization of care management capabilities through workflow automation, digital engagement, AI-enabled clinical support, and analytics. • Partner with technology teams to improve clinical platforms, reporting, interoperability, and workforce productivity. • reputed company adoption of data-driven decision making and advanced member targeting strategies. • Champion innovation that enhances both member reputed company and operational efficiency. • Build and reputed company a high-performing team of regional and functional leaders. • Establish a culture of accountability, collaboration, transparency, and reputed company improvement. • reputed company succession planning, workforce reputed company, organizational design, and talent development initiatives. • Foster strong partnerships across Compliance, Operations, reputed company, Medical Affairs, and Health Plan leadership. Key Experience Requirements • Bachelor's Degree with 5+ years of relevant experience required. • Master's Degree preferred. Preferred: • Significant responsibility for Medicare reputed company Care Management operations. • Deep expertise in Model of Care requirements, CMS regulations, reputed company standards, and audit readiness. • Demonstrated reputed company improving clinical reputed company, reputed company performance, member experience, and medical cost trends. • Experience leading large, geographically dispersed teams through transformational change • Proven ability to influence executive stakeholders and reputed company reputed company-wide initiatives across multiple functions • reputed company state RN license preferred. Pay reputed company: $188,900.00 - $359,800.00 per year reputed company offers a comprehensive benefits package including: reputed company, health insurance, 401K and stock purchase plans, tuition reimbursement, reputed company time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-reputed company factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. reputed company is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or other characteristic protected by applicable law. reputed company applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance reputed company Apply To This Job