Business and Strategic Planning

• Build and facilitate repeatable business management processes that support Medicare Advantage and Medicare Supplement growth, profitability, compliance, and operational performance, including progress evaluation and communication to affected stakeholders.

• Lead the coordination, planning and facilitation of various departmental/divisional events (i.e. Departmental Summits, All Hands Meetings, Leadership Planning Sessions, staff meetings) to make them more effective, purposeful and outcomes based.

• Partner with leadership to monitor business performance and key Medicare value drivers including Risk Adjustment, Star Ratings, CAHPS performance, provider enablement, operational efficiency, retention, and membership growth.

• May produce segment business plans and analysis under guidance from Segment Lead.

• Facilitate the adoption of standard operating procedures and processes for the department and assist with the communication and education of new SOPs outside of the department. 

• Facilitate change management work to support business and process improvements and overall departmental/divisional effectiveness.

Project Management

• Lead special projects for the department/division/segment as assigned.  Possible duties could include:

• Evaluation of potential opportunities and recommendations to reduce costs/improve efficiencies

• Review and evaluation of best or next practice opportunities for potential adoption

• Develop recommendations based on industry trends, CMS guidance, competitive intelligence, and market dynamics impacting Medicare Advantage and Medicare Supplement performance, growth, quality outcomes, and operational effectiveness.

• Serve as lead on engagements with external entities (i.e. consultants) and coordinate data gathering and research efforts based on the direction of leadership.

• Manage tracking of initiatives/projects for the department/division/segment and independently create presentations of initiative/project progress for varied audiences, which may include ILT and Senior Leadership.

Data Analysis/Reporting

• Identify trends, risks, and opportunities impacting Medicare Advantage and Medicare Supplement performance and develop actionable recommendations for leadership.

• Coordinate departmental/divisional budget analysis, provide input into and monitor budget forecasts and review progress against administrative cost reduction goals

• Track and evaluate goal progress, including data collection and analysis of key performance metrics (KPIs)

Business Partnerships

• Improve and strengthen business partnerships and stakeholder relationships for the department/division through focus on proactive communications, relationship building, and process improvements

• Facilitate the completion of the Annual Report, CEO/Board reports, and other marketing/communication opportunities with a focus on partnering to deliver communications that are relevant and oriented to specific business partnerships both internal and external. 

• Provide input and recommended strategy for leadership’s public speaking engagements and/or industry Board or committee meetings.

• Coordinate and manage vendor relationships as required by business operations’ needs.