Job Opportunities in United States

Blue Cross and Blue Shield of Kansas is looking to for a team member to hold the position of Director of Medicare Programs. The position is accountable to the Associate Vice President of Government Programs for the operational and strategic components of Medicare Advantage (MA), Medicare Supplement and Part D (PDP) programs. This position must have a breadth of knowledge related to product development, sales, operations, medical management, vendor management and compliance to maintain successful CMS programs. Responsible for the oversight and ongoing strategic direction for BCBSKS’s MA, Medicare Supplement and PDP programs, including operational success, vendor oversight, revenue management, and ensuring compliance with all government requirements.

“This position is eligible to work remotely (8 or less days a month onsite) or hybrid (9 or more days a month onsite) in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment.” Applicant must report to the Topeka campus as required for trainings or onsite meetings.

Why Join Us?

• Family Comes First: Total rewards package that promotes the idea of family first for all employees; including paid time off and family first leave.
• Professional Growth Opportunities: Advance your career with ongoing training and development programs both through our internal Blue University and external opportunities.
• Dynamic Work Environment: Collaborate with a team of passionate and driven individuals.
• Make a Positive Impact: Your work will directly contribute to the health and well-being of Kansans.
• Stability: 80 years of commitment, compassion, and community
• Lead and Inspire: Guide and mentor your team to achieve their full potential and success.
• Balance: paid vacation and sick leave with paid maternity and paternity available immediately upon hire
• Real World Experience: You will work hand in hand with our team in learning our business and applying your classroom learning.
• Networking Opportunities: Participate in our corporate intern program and network with other interns at BCBSKS to enhance your learning opportunity.

Exempt Grade 20

• Blue Cross and Blue Shield of Kansas offers excellent competitive compensation with the goal of retaining and growing talented team members. The compensation range for this role is a good faith estimate, it is estimated based on what a successful candidate might be paid. All offers presented to candidates are carefully reviewed to ensure fair, equitable pay by offering competitive wages that align with the individual's skills, education, experience, and training.

• Participate in development of the overall strategy for the MA, Medicare Supplement and PDP line of business, including the product and bid development and reconciliation processes.
• Responsible for overseeing the MA, Medicare Supplement and PDP line of business operations, including CMS submissions and attestations, vendor management, and coordinating efforts with internal functions such as Sales, Marketing, Provider Relations, Finance and Compliance.
• Oversee the financial business case to support product growth, operational excellence and compliance for MA, Medicare Supplement and PDP programs.
• Direct liaison with Federal regulators, ensuring compliance with all CMS rules and regulations in the ongoing operations of all Medicare programs.
• Oversees and monitors the implementation of new Medicare contractual and policy requirements, new legislation and regulations.
• Monitor and analyze the changing Medicare landscapes and recommended programs and policies to proactively address the changing needs of our membership.
• Builds strong collaborative relationships both internally and with external partners, including CMS officials, to drive program success and address challenges where presented.
• May involve preparation of presentations and materials for professional partnering meetings, seminars, conferences, the Steering Committee and the Board.

• Bachelor's degree, preferably in Business Administration, Economics or Public Health. In lieu of a degree, 6 years in the health care delivery industry.
• Previous Blue Plan related experience preferred.
• Two years experience in strategic management and leadership directing substantial resources required.
• A thorough understanding of Medicare Advantage and/or Prescription Drug Plans is preferred.
• Strong experience developing and launching products preferred.
• Experience working and building relationships with governmental agencies.
• Demonstrated track record of leading and delegating to a team with accountability and successful achievement of financial results.

• Base pay is only one component of your competitive Total Rewards package:
  • Incentive pay program (EPIP)
  • Health/Vision/Dental insurance
  • 6 weeks paid parental leave for new mothers and fathers
  • Fertility/Adoption assistance
  • 2 weeks paid caregiver leave
  • 5% 401(k) plan matching
  • Tuition reimbursement
  • Health & fitness benefits, discounts and resources

Salary