Manager, Medicare Operations

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.

Summary 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.

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.   Conduct s   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 strategie s .   Support s   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.   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.

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.

Bachelor's degree preferred in Business, Healthcare administration, public health or related field.  Anticipated Weekly Hours 40 Time Type Full time