Lead Director of Medicare Sales - Northern California
Company: CVS Pharmacy
Location: Sacramento
Posted on: January 26, 2023
|
|
Job Description:
Search by job title, category, or Military MOS code Lead
Director of Medicare Sales - Northern CaliforniaJob Description
**Qualified candidates will be in the Northern CA market**
This position reports to the CA Medicare Chief Medicare Officer and
will work with key business partners to evaluate, document, and
implement business requirements specific to the California
Market.
Serves as a subject matter expert on Medicare operations and
business process improvement in a capitated HMO structured model
where health plan functions are delegated to contracted Medical
Groups.
In this role, candidate will partner with functional areas to
conduct an end-to-end assessment of the member experience to define
requirements, identify and document gaps in processes, identify key
stakeholders, solutions, and prioritization for resolution.
This individual will be responsible to lead and implement
operational system enhancements and process improvements to ensure
that requirements are built into multiple Aetna business platforms
including but not limited to enrollment, sales, provider search,
customer support, claims processing, etc. to close gaps and ensure
alignment between Aetna and our contracted Medical Groups.
Candidate will be accountable for owning critical projects and
driving them to completion to promote operational excellence and
improve metrics related to member and provider experience.
Individual will also maintain operational reporting and conduct
monthly capitation audits. Candidate must be resourceful and
creative to navigate through multiple departments and operate
strategically to improve system functions and able to implement and
track multiple projects from end to end.Pay Range
The typical pay range for this role is:
Minimum: 105,000
Maximum: 226,600Please keep in mind that this range represents the
pay range for all positions in the job grade within which this
position falls. The actual salary offer will take into account a
wide range of factors, including location.Required
Qualifications
- 5+ years' experience in Medicare product and/or health plan
operations, or managed care programs.
- 3+ years' experience in implementation and process improvement
projects.
- 3+ years' experience in California delegated network model.
- 0-10% travel may be requiredPreferred Qualifications
- MS Excel - Advanced
- Tableau - Advanced
- Lean Six Sigma Certification
- Process Flow Management
- Advanced analytical skills
- 3-5+ years' experience in project managing/reporting/system
- Healthcare background with knowledge of the CA Market health care
delivery system, Delegated Network Models, Medicare Advantage,
Managed Care, Medicare operations, Medicare Stars, Member
Experience KPIs
- Hybrid Work Model- 2 days in office; 3 Days Remote is an
option.Education
MBA, Business Administration or equivalent work experience.Business
Overview
Bring your heart to CVS Health Every one of us at CVS Health shares
a single, clear purpose: Bringing our heart to every moment of your
health. This purpose guides our commitment to deliver enhanced
human-centric health care for a rapidly changing world. Anchored in
our brand - with heart at its center - our purpose sends a personal
message that how we deliver our services is just as important as
what we deliver. Our Heart At Work Behaviors--- support this
purpose. We want everyone who works at CVS Health to feel empowered
by the role they play in transforming our culture and accelerating
our ability to innovate and deliver solutions to make health care
more personal, convenient and affordable. We strive to promote and
sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal
opportunity employer, as are the physician-owned businesses for
which CVS Health provides management services. We do not
discriminate in recruiting, hiring, promotion, or any other
personnel action based on race, ethnicity, color, national origin,
sex/gender, sexual orientation, gender identity or expression,
religion, age, disability, protected veteran status, or any other
characteristic protected by applicable federal, state, or local
law. We proudly support and encourage people with military
experience (active, veterans, reservists and National Guard) as
well as military spouses to apply for CVS Health job
opportunities.
Apply
Keywords: CVS Pharmacy, Sacramento , Lead Director of Medicare Sales - Northern California, Executive , Sacramento, California
Click
here to apply!
|