Director of Medicare Products

This role will oversee the the development, implementation, and optimization of the Medicare product portfolio, owning the full spectrum of product strategy and operations.



<p><strong>VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and rehabilitation services.&nbsp;</strong></p> <p><strong>Our mission is to promote healing, better health and well-being to the fullest extent possible. &nbsp;<br /><br />Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has provided health care services to individuals residing within New York City for over 40 years.</strong></p>

keywords: growth initiatives,member oversight,planning,analysis,audit preparation,education,experience,knowledge


Overview: The Director of Medicare Products will support the Plan's strategic priorities as they relate to growth of the current portfolio and new expansion initiatives.
Responsibilities: Identify and lead initiatives to ensure operational areas are accurately and efficiently supporting the regulatory, compliance and business requirements specific to the Medicare products as mandated from Centers for Medicare and Medicaid Services (CMS), and the NYS Department of Health (DOH). You will lead product analysis to gain a comprehensive understanding of internal and external environmental influences and competitive pressures. Incorporate results into product planning and development.Develop a deep understanding of the Medicare industry, keep abreast of upcoming demonstrations, program changes, and proposed legislation.Manage the CMS bid process, collaborates with Actuary, Sales, and other teams to develop product inputs, pricing and other key assumptions. Coordinate all supporting and related activities.Support the development of product portfolios, benefits, and programs that drive membership growth, improve member satisfaction, and enhance revenue &amp; profitability. Support plan staff in preparing for any audit activities or readiness reviews.
Requirements: We&nbsp;are looking to speak with those who bring a Bachelor's Degree along with <em><strong>5+ experience at a Health Plan with Medicare. </strong></em>Master's degree in business, healthcare or public administration strongly preferred. Must be able to successfully facilitate sound business objectives within highly regulated industry. Experience leading teams, including both managers and individual contributors, to identify opportunities, develop plan of action, and execute.Thorough knowledge of Medicare regulatory requirements, including risk adjustment.Thorough understanding of interconnected managed care operations.Excellent analytical skills demonstrated by an ability to use actionable data to support decision-making, and to proactively identify opportunities.