Director, Medicare Advantage Administration

<strong>At Emergent Holdings, we&rsquo;re creating an innovative environment where our employees belong authentically, contribute meaningfully, and thrive intentionally &mdash; both personally and professionally.</strong>

Southfield, USA

Emergent Holdings

<p class="p1"><strong>Emergent Holdings is driven by a singular goal &mdash; improving the health and safety of our customers and our communities. How do we do that? We create innovative insurance products, technology solutions, and services to support our key stakeholders &mdash; individuals, employers, providers, and strategic partners &mdash; improving the health and safety of the people and places we serve.</strong></p>

keywords: job description,work environment,compensation,strategy,operations,analysis,planning,performance,quality assurance,education & experience,initiative,skills,knowledge


Competitive Compensation and Benefits Package

Overview: The Director, Administration acts as a strategic partner to the Vice President, Risk Adjustment, Quality, and Analytics (RQA) providing support in executing the organization's vision including strategy and driving operational excellence. The ideal candidate will have strong analytical skills, exceptional communication abilities, and expertise in Risk Adjustment (RA), Quality (QI), and Cost of Care (Coc) for the Medicare Advantage book of business. They will be responsible for coordinating internal and external resources to achieve organizational goals while maintaining a high level of professionalism.&nbsp;<br /><br /> <p><strong>WORKING CONDITIONS:</strong>&nbsp;</p> <p>Work is performed in a virtual office and field setting with no unusual hazards. Travel is required, with some occasional overnight stays. Must possess a valid driver's license with a record that meets corporate standards. Work is required at various times of the day and sometimes weekend work may be required.&nbsp;&nbsp;&nbsp;</p> <p><em>Pay Range - Actual compensation decision relies on the consideration of internal equity, candidate&rsquo;s skills and professional experience, geographic location, market, and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $120,900 and $202,500.</em></p>
Responsibilities: <p><strong>Strategic Support:<br /><br /></strong></p> <ul> <li>Work directly with the Vice President to develop, organize and implement the annual and long-term strategies of the MA segment, partnering with enterprise and segment business unit teams as appropriate.</li> <li>Provide strategic support to the Vice President, RQA, the President Medicare Advantage and other key executive staff by conducting research, preparing materials, and advising on key decisions and initiatives related to risk adjustment, quality, and cost of care.</li> <li>Collaborate with, and manage, cross-functional teams to develop and execute strategic plans and ensure alignment with the overall business objectives.</li> <li>Structure annual planning process and monthly business reviews; including timeline, tracking, reporting and presentation of information.</li> <li>Identify and prioritize business levers of growth, create and review metrics and plans for success.</li> <li>Lead strategic initiatives including product development, implementation and execution in partnership with key stakeholders across the enterprise.</li> </ul> <br /> <p>Serve as an advisory and/or proxy:</p> <ul> <li>Serve as a trusted strategic advisor to the Vice President on division-wide priorities, goals, and initiatives.</li> <li>Provide talking points and/or prep the Vice President on meeting subject and material.</li> <li>Continuously seek opportunities to optimize the Vice President's productivity, removing bottlenecks and streamlining decision-making processes.</li> <li>Ensure the Vice President&rsquo;s involvement in decision making and initiatives takes place at key and appropriate times.</li> <li>Represent the Vice President in meetings and engagements as needed, serving as a trusted proxy to drive strategic alignment and decision-making.</li> <li>Act as a liaison between the Vice President and key stakeholders.</li> <li>Drive P&amp;L performance of the RQA team.</li> </ul> <br /> <p><strong>Project Management:<br /><br /></strong></p> <ul> <li>Develop and implement processes to streamline decision-making, communication, and project management across the organization.</li> <li>Oversee the development and implementation of internal processes and systems, identifying areas of improvement and ensuring efficient operations.</li> <li>Track high priority initiatives, identify issues and solutions, mitigate obstacles, and communicate status to the Vice President, including other executives or team members as necessary.</li> <li>Responsibility for balancing workload to optimize the effectiveness of the department.</li> <li>Lead special projects and programs impacting overall success of the segment.</li> </ul> <br /> <p>Serve in an administrative capacity:</p> <ul> <li>Support and provide direction to the Executive Assistant by filling in knowledge gaps and coordinating completion of various requests.&nbsp;</li> <li>Plan and execute executive meetings including facilitation, agenda creation for Vice President and relevant stakeholders, follow up needs and more.</li> <li>Oversee and direct the development of performance scorecards, metrics and dashboards.</li> <li>Establish a rhythm of regular team meetings, business reviews and offsites for the executive and leadership teams; maintain the management of team agenda and meetings, track key strategic actions and driving them to closure.</li> <li>Assist with the annual budget cycle process such as helping department heads prepare their budget materials for presentation to the Vice President.</li> <li>Partner with internal stakeholders in managing the planning process, ensuring coordination with corporate priorities, as well as planning group level priorities and alignment of resources.</li> <li>Maintain a birds-eye view of the business, connecting the dots across the division; improve coordination and communication across functional areas (RA, QI, CoC).</li> <li>Complete and coordinate requests directed to Vice President from other executives.</li> <li>Ensure essential information is synthesized to the executive team and that business decisions are shared with the appropriate teams.</li> </ul>
Requirements: <ul> <li>Minimum seven (5) years of leadership experience.</li> <li>Five (7) years of health plan leadership &amp; strategic solution development experience.</li> <li>Bachelor&rsquo;s degree in insurance or related field required.</li> </ul> <br /> <p><strong>QUALIFICATIONS</strong></p> <p>To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.<br /><br /><br /></p> <p><strong>OTHER SKILLS AND ABILITIES&nbsp;</strong></p> <ul> <li>Possess a strategic mindset with the ability to align detailed work to the big picture, identifying what is urgent vs important.</li> <li>Demonstrated ability to work independently in the research, planning, development, and implementation of cross-functional projects; Ability to appropriately manage resources, budgets, issues, and risks for the successful completion of projects.</li> <li>Strong technical skills, with the ability to leverage digital tools to achieve objectives.</li> <li>Highly developed communications skills (written/verbal) and emotional intelligence with the ability to influence; Able to build credibility, relationships, and networks quickly across a variety of stakeholders.</li> <li>Ability to understand business needs and conceptualize and implement processes and products that support those business strategies.</li> <li>Ability to comprehend the consequences of various problem situations and seek creative solutions.</li> <li>High level of professionalism, discretion, and judgment in dealing with confidential and sensitive information.</li> <li>Process-oriented; enjoys creating order where it is needed.</li> <li>Comfortable in supporting others&rsquo; success&mdash;performed with low ego and the ability to anticipate the needs of busy executives.</li> <li>Ability to excel in an ambiguous environment, orchestrating strategic and complex business activity.</li> <li>Strong analytical and problem-solving skills, with the ability to think critically and develop creative solutions.</li> <li>Excellent organizational skills:&nbsp;innate ability to thrive in a fast-paced, dynamic, virtual environment with competing priorities.</li> </ul> <br /> <p><em>The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.&nbsp; &nbsp;</em>&nbsp;</p> <p><em>We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract.</em>&nbsp;</p>