Director, Group Medicare

The Group Medicare team oversees all aspects pertaining to the strategy, enrollment growth, day-to-day management, retention, compliance, and financial performance of Blue Shield of California’s Group Medicare membership. The Director, Group Medicare will report to the Senior Director, Medicare Growth. In this role you will be responsible for developing and executing on the strategic growth plan for our Group Medicare product, representing a critical and growing membership base. Accountabilities will include retention, financial targets, Medicare Stars, and Risk Adjustment for client accounts in this product. Another critical accountability will be building and maintaining the operational infrastructure through matrixed relationships to support Medicare Advantage PPO in preparation for a state-wide launch of the product. This role is critical to Medicare and Blue Shield achieving our long-term strategy goals. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.Your WorkIn this role, you will:Develop and execute short and long-term strategic growth plan for Group Medicare, including meeting sales/retention targets and financial operating income goals.Lead matrix relationships within Blue Shield related to Group Medicare accounts to build infrastructure around the PPO product, including capabilities around member engagement, operations, and utilization management; this includes leading governance process and ongoing oversight of Group Medicare capabilities and overseeing workstreams and deliverables to ensure Blue Shield delivers on Group Medicare quality, membership, and OI outcomes.Manage a team of professionals to ensure the Group Medicare business meets its business goals in a compliant manner.Support Commercial Account Executives who manage overall relationships with accounts and consultants, represent Blue Shield in final round bid interviews and ongoing client meetings to understand their needs and ultimately retain client accounts, may also lead open enrollment meetings for key accounts.Consult with Commercial clients on Medicare line of business to drive member outcomes which result in meeting client’s goals and objectives while achieving corporate goals, and build out specific client outcomes to report-out to show our effectiveness in Medicare Stars and risk adjustment scores.Achieve or exceed Operating Income goals for BSC’s Group Medicare membership.Achieve or exceed operational, quality (Medicare Stars), retention, and risk adjustment goals for client accounts.Qualifications

Your Knowledge and ExperienceRequires a bachelor's degree in business, marketing, communication or equivalent experience.Requires at least 10 years of prior relevant experience including 6 years of management experience.Requires 10 years of experience in Medicare with at least 5 years managing or working with Group Medicare accounts and/or Account Management for Group Medicare accounts at a manager or higher level.Requires experience working on Medicare Advantage products, including the annual bid process.Prior experience working with Medicare Advantage PPO product and membership preferred.Pay Range:The pay range for this role is: $165,990.00 to $248,930.00 for California.About Blue Shield

Blue Shield of California’s mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our continued commitment to diversity, equity, and inclusion upholds our values and advances our goal of creating a healthcare system that is worthy of our family and friends while addressing health disparities, promoting social justice, and integrating health equity through our products, business practices, and presence as a corporate citizen.Our Values:Honest . We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.Human . We strive to be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes.Courageous . We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.Our Workplace Model:Blue Shield of California is dedicated to making work-life balance a reality. Whether you prefer to work in an office or from home, we understand flexibility is more important than ever. That’s why Blue Shield is a hybrid company, offering you the opportunity to decide where you can do your best and most meaningful work.Job Info

Job Identification

20241440Job Category

SalesPosting Date

08/29/2024, 08:57 PMJob Schedule

Full timeRole can be filled by a candidate requiring sponsorship

No

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