Job Description
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.
This is a hybrid role that requires working 2-3 days a week from the St. Louis, Minnesota office.
Position 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.
What you will do
- 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.
Requirements:
- Must reside within commutable distance from the St. Louis, MN office.
- 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.
Preferred Qualifications
- 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.
Education
- Bachelor's degree preferred in Business, Healthcare administration, public health or related field.
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$66,330.00 - $145,860.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Numbers & Facts
| Location | St Louis, Minnesota |
| Industry | Biotechnology/Pharmaceuticals |
| Company Size | 10,000 employees or more |
| Website | https://cvshealth.com/ |
About Company
CVS Health offers a world of promising job opportunities across a diverse range of careers in everything from corporate and pharmacy roles to retails positions. No matter where you work at CVS Health, your unique skills, talents and abilities are welcome and valued. We recognize and reward greatness and want our employees to know their work is making a difference in the lives of millions. Join us today. Together we can continue making innovative, high-quality health and pharmacy services safe, affordable and accessible – for all.
Skills
- Analysis Skillsunmatched
- Business Strategyunmatched
- Communication Skillsunmatched
- Competitive Analysis/Strategyunmatched
- Cross-Functionalunmatched
- Establish Prioritiesunmatched
- Geographyunmatched
- Governmentunmatched
- Government Fundingunmatched
- Health Insuranceunmatched
- Healthcareunmatched
- Healthcare Administrationunmatched
- Incentive Programsunmatched
- Leadershipunmatched
- Maintain Complianceunmatched
- Market Shareunmatched
- Medicareunmatched
- Microsoft Excelunmatched
- Microsoft Officeunmatched
- Operational Improvementunmatched
- Operational Supportunmatched
- Operations Managementunmatched
- Performance Analysisunmatched
- Performance Metricsunmatched
- Presentation/Verbal Skillsunmatched
- Problem Solving Skillsunmatched
- Process Improvementunmatched
- Product Supportunmatched
- Project Management Certificationunmatched
- Project Management Professional (PMP)unmatched
- Project/Program Managementunmatched
- Public Healthunmatched
- Quality Assuranceunmatched
- Regulatory Complianceunmatched
- Retention Programsunmatched
- Revenue Growthunmatched
- Safety/Work Safetyunmatched
- Salesunmatched
- Sales Managementunmatched
- Service Deliveryunmatched
- Strategic Planningunmatched
- Writing Skillsunmatched
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