Manager, Medicare Operations
About The Position
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. The Manager of Medicare Operations is responsible for designing and implementing enterprise-wide solutions that address business challenges within our Medicare organization for Allina Health | Aetna. This role is pivotal in shaping organizational strategy, ensuring compliance, and enhancing operational effectiveness to maintain our competitive edge in the marketplace. The ideal candidate will partner with business owners to achieve strategic objectives, including profitable growth and improved service delivery.
Requirements
- 3-5 years of experience in health insurance, Medicare, or a related government-sponsored healthcare program.
- 2+ years of project management, program management, or operational leadership experience.
- Demonstrated experience leading cross-functional initiatives and influencing stakeholders without direct authority.
- Strong analytical and problem-solving skills with the ability to leverage data to drive business decisions.
- Proven ability to plan, execute, and deliver complex projects and operational initiatives.
- Excellent written, verbal, and presentation communication skills.
- Advanced proficiency in Microsoft Excel and Microsoft Office applications.
Nice To Haves
- Medicare Advantage operational experience.
- Experience supporting AEP readiness, Medicare bid development, or regulatory compliance activities.
- Project Management Professional (PMP) certification or equivalent project management training.
- Experience using Quickbase or similar workflow/project management platforms.
- Experience working with sales, account management, and market leadership teams to support growth and retention initiatives.
Responsibilities
- Oversees day-to-day operations of the organization's Medicare program to support operational excellence, market readiness, and member retention.
- Supports market team by developing and executing on cross-enterprise initiatives that ensure efficient and effective delivery of services.
- Conducts quality assurance reviews to ensure year-over-year updates and accuracy in Medicare member materials and resources.
- Assesses the development of government program opportunities, develops strategies, presents recommendations, and implements solutions to improve overall line of business performance.
- Works closely with the local account management and sales teams on growth and retention strategies.
- Supports the investigation and remediation of operational issues as they arise, serving as the liaison between the market team and national partners.
- Defines & drives process improvement and operational projects in collaboration with senior management, stakeholders, and senior individual contributors.
- Manage year-over-year AEP readiness activities including support for product and vendor implementations, benefit and material reviews and market trainings.
- Support the annual Medicare bid filing by conducting required analysis, consolidating competitive information, and helping to manage bid tools.
- Establish and monitor key performance indicators (KPIs) to evaluate the success of programs and initiatives.
Benefits
- medical
- dental
- vision coverage
- paid time off
- retirement savings options
- wellness programs
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What This Job Offers
Job Type
Full-time
Career Level
Manager
