Career Opportunities: Sr Vice President, Medicare (24745)

Candidates hired for remote positions must reside in Oregon, Washington, Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin.

Job Summary

This position is responsible for strategy, growth, and oversight of the Medicare Advantage line of business.  Time is focused on enterprise-wide engagement, as well as business group oversight.  Primary duties include strategic planning and leadership, as well as development and oversight of resources, relationships, and teams.  The position will accomplish goals within a matrixed team approach that involves staff across the organization and actively and regularly participates in strategic planning and collaboration. 

Essential Responsibilities

Technical/Strategic Leadership

• Provides strategic leadership for the Medicare line of business across the organization.
• Oversees problem identification, solution development and implementations necessary to ensure the performance of the Medicare line of business. 
• Develops and leads a governance model that ensures understanding and alignment of the Medicare program across intersecting departments, matrixed relationships, and external parties.
• Ensures the development and deployment of reporting and analytics utilized to oversee Medicare’s operations and support strategic efforts.
• Ensures internal systems, controls and measures are in place to enhance effective, efficient, and compliant operations.
• Identifies performance metrics and ensures the timely and accurate monitoring and reporting of performance against metrics.
• Ensures the Medicare program meets all CMS, OHA, contractual and other requirements.
• Promotes innovation, process review and continual improvement.
• Maintains a deep understanding of CareOregon operations and functions to effectively navigate  across the organization.
• Provides organizational leadership to ensure Medicare’s operating model is effective and efficient
• Serves as a sponsor for key projects and initiatives.

Strategic Planning

• Actively and regularly participates in strategic planning and collaboration at the organizational level.
• Provides counsel to the organization’s executive leadership on specific areas of short and long-term planning related to the Medicare business.
• Leads the development of vision and goals for areas of oversight.
• Develops and refines strategic plans in alignment with organizational vision and goals.
• Defines operational structure for areas of oversight and approves policies.
• Maintains an enterprise view while establishing business unit priorities.

Financial/Resource Management

• Counsels on financial and labor allocations across the organization, including people, finances, and timelines.
• Develops budgets in alignment with strategic planning.
• Ensures teams have sufficient resources to perform their work.
• Ensures budgets are monitored and managed effectively across areas of oversight.
• Approves resource allocations within budget, including people, finances, and timelines; make decisions on exceptions.

Relationship Management

• Ensures strategic messages are regularly and effectively relayed to management team and staff; promotes transparency.
• Leverages current relationships and forges and leverages new relationships with community partners, provider networks, and other constituents in alignment with organizational direction and priorities.
• Collaborates with leaders across the organization in identifying integrated improvement strategies and ensuring meaningful integration.
• Represents the organization in external meetings and functions, providing strong leadership presence and effectiveness.

Employee Supervision

• Directs team(s) and establishes team direction and goals in alignment with the organizational mission, vision, and values.
• Identifies work and staffing models; recruits, hires, and oversees a team to meet work needs, using an equity, diversity, and inclusion lens.
• Identifies department priorities; ensures employees have information and resources to meet job expectations.
• Leads the development, communication, and oversight of team and individual goals; ensures goals, expectations, and standards are clearly understood by staff.
• Manages, coaches, motivates, and guides employees; promotes employee development.
• Incorporates guidance from CareOregon equity tools into people leadership, planning, operations, evaluation, budgeting, resource allocation, and decision making.
• Ensures team adheres to department and organizational standards, policies, and procedures.
• Evaluates employee performance and provides regular feedback to support success; recognizes strong performance and addresses performance gaps and accountability (corrective action).
• Performs supervisory tasks in collaboration with Human Resources as needed.

Organizational Responsibilities

• Performs work in alignment with the organization’s mission, vision and values.
• Supports the organization’s commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.
• Strives to meet annual business goals in support of the organization’s strategic goals.
• Adheres to the organization’s policies, procedures and other relevant compliance needs.
• Performs other duties as needed.

Experience and/or Education

Required

• Minimum 12 years’ related experience, including 5 years’ experience with Medicare Advantage plans
• Leadership experience in a managed care organization or in a position requiring advanced knowledge of Medicare Advantage regulations

Preferred

• Minimum 5 years’ experience in a supervisory position
• Experience with the dual eligible population
• Bachelor’s or Master’s degree in health care administration, public policy, business, or a related field

Knowledge, Skills and Abilities Required

Knowledge

• Advanced knowledge of Medicare, the Medicare Advantage program and CMS
• Strong understanding of managed care and publicly financed health care stewardship principles
• Strong understanding of financial structures, fiscal responsibility, and the economic impact of business decisions
• Understanding of best practices that drive an environment of continuous improvement

Skills and Abilities

• Leadership effectiveness; ability to design and implement constructive change with a growth mindset
• Highly effective written and verbal communication skills, as well as strong presentation skills
• High degree of initiative and motivation along with the ability to effectively collaborate and plan with departmental leadership, staff, and other stakeholders/customers
• Highly effective strategic planning and resource management skills at an enterprise level
• High degree of diplomacy, credibility, and persuasiveness to consistently cultivate effective working relationships across a matrixed organization; ability to effectively express ideas and gain acceptance

• Ability to navigate and meet state and federal compliance requirements
• Ability to work effectively with diverse individuals and groups

• Ability to learn, focus, understand, and evaluate information and determine appropriate actions
• Ability to accept direction and feedback, as well as tolerate and manage stress
• Ability to see and hear for at least 6 hours/day
• Ability to read, speak clearly, and perform repetitive finger and wrist movement for at least 3-6 hours/day

Working Conditions

Work Environment(s):    ☒ Indoor/Office    ☐ Community      ☐ Facilities/Security     ☐ Outdoor Exposure

Member/Patient Facing:    ☒ No                          ☐ Telephonic        ☐ In Person

         Hazards:  May include, but not limited to, physical and ergonomic hazards.

Equipment:  General office equipment

Travel:  May include occasional required or optional travel outside of the workplace; the employee’s personal vehicle, local transit or other means of transportation may be used.

Work Location: Work from home

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Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment.

Veterans are strongly encouraged to apply.

We are an equal opportunity employer. CareOregon considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or veteran status.

Visa sponsorship is not available at this time.