Medicaid Sales Director - Arizona Mercy Care

CVS Health•Work At Home-Arizona, AZ

1d•$105,000 - $231,132•Remote

About The Position

This position is remote, but must sit in Arizona. This role oversees the operational and regulatory execution of the Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) program. This role ensures seamless integration of Medicare and Medicaid functions, drives compliance with CMS and state requirements, and supports performance across quality, operations, and member experience. The position is responsible for leading and executing sales strategies to drive growth in the Medicare Advantage Dual-Eligible Special Needs Plan (D-SNP) line of business. This role oversees sales teams, broker relationships, market development, call center operations, and community development efforts to achieve enrollment targets, optimize distribution channels, and deliver a high-quality member experience.

Requirements

Active health insurance license and AHIP certification REQUIRED
5+ years of experience in Medicare Advantage, Medicaid, or managed care operations
Extensive knowledge of Medicare Advantage, AHCCCS, CMS regulations and D-SNP requirements
Strong cross-functional leadership and regulatory/compliance experience
Proven leadership experience managing sales team, call center, and community outreach
Demonstrated success achieving aggressive sales and retention targets
Data analysis and performance management capability
Ability to effectively communicate with executive level management

Nice To Haves

Experience with D-SNP or dual-eligible populations
Familiarity with AHCCCS, LTSS, or integrated care models
Experience supporting CMS audits or NCQA accreditation

Responsibilities

Lead day-to-day administration of D-SNP operations across Medicare and Medicaid functions
Ensure compliance with CMS, state (e.g., AHCCCS), and contractual requirements
Coordinate cross-functional teams including operations, marketing, enrollment, care management, compliance, and network
Oversee integrated processes such as enrollment, claims, grievances & appeals, and care coordination
Support D-SNP Model of Care execution, including care management and member engagement strategies
Monitor performance metrics (e.g., STAR ratings, quality, operational KPIs) and report to leadership
Identify and implement process improvements to enhance integration and member outcomes
Develop and implement comprehensive sales strategies to drive growth and member retention
Achieve and exceed enrollment targets
Analyze market trends, competitor activity, and regulatory changes to inform strategy
Identify and expand opportunities in key service areas
Build and execute local market growth plans
Optimize marketing channel mix including brokers, agents, telesales, and community development, and various marketing methodologies
Recruit, train, and coach new hires on product, regulatory (State and Federal), and compliance requirements
Educate and develop internal sales representatives
Ensure full and accurate communication of benefits and disclosure of restrictions are presented to each prospect, including provider and medication confirmations
Document oversight on all areas of the sales and retention process
Set performance expectations and monitor results
Ensure all sales activities adhere to CMS Marketing and Communication Guidelines
Maintain accurate documentation and reporting standards
Oversee Medicare sales call center operations, including inbound and outbound activity
Ensure call center performance meets KPIs such as call quality, compliance scores, and service levels
Partner with operations teams to optimize staffing models, scripting, training, and technology platforms
Drive continuous improvement in customer experience and sales effectiveness within the call center environment
Ensure successful CMS Call Center Monitoring Audit
Provide oversight of sales administration functions including reporting, forecasting, enrollment processing, and documentation
Ensure accurate tracking of sales metrics, commissions, and performance reporting
Establish and maintain standardized processes for sales operations and compliance documentation
Partner with internal teams to improve workflows, reduce errors, and enhance operational efficiency