Remote Manager, Medicare Operations

About Our Client

The hiring company eases the burden on doctors with excessive processes and aims to restore their independence. The team includes physicians, public health experts, technologists, healthcare innovators, and risk management professionals. They recently announced a partnership with a large healthcare company. The company supports primary care providers with an unpredictable business model and an aging population. Physicians can allocate their time better with patients, increasing autonomy, incentivizing better outcomes, and optimizing risk through an intelligent marketplace.

The Center for Medicare and Medicaid (CMS) is launching a new value-based care program to disrupt Traditional Medicare, and the hiring company believes that this represents an opportunity to achieve the meaningful change they envision.

About The Role

The hiring company is looking for a stellar Medicare Operations Manager to join their ACO Operations and Strategy team as a subject matter expert and operator of Medicare ACO programs. This candidate will work cross-functionally with the Customer Success, Product, Performance Operations, Clinical Strategy, Data Science, and Growth teams to drive the operational excellence of the ACOs on behalf of provider partners.

This role demands a strategic thinker who wants to implement initiatives across the growing value-based care lines of business. Strong attention to detail and the ability to work independently and collaboratively in a fast-paced environment will be crucial in this role.

• Lead cross-functional initiatives related to the efficient and seamless operation of Medicare ACOs, including voluntary alignment, health equity planning, quality measure management, CMS communications, etc.
• Support the execution of the quality measurement and reporting program on behalf of payer and provider partners.
• Engage in the CMS submission process of information to contractual partners on behalf of the providers and ensure adherence to all ACO program-related requirements.
• Collaborate and manage touchpoints with external stakeholders, including the federal government, national advocacy organizations, and other partners.
• Operationalize patient- and provider-facing programs to support patient engagement in their healthcare journey.

Who you are. . .

• Bachelor’s degree or equivalent work experience.
• 3+ years of experience in healthcare operations roles and/or excited and eager to learn more about Medicare ACO operations with a proven record of success
• Deep understanding of the healthcare industry, emphasizing Medicare programs (eg. ACO REACH, MSSP, Medicare Advantage).
• Highly analytical (strong previous utilization of spreadsheets) and passion for data-driven problem-solving with experience in interpreting clinical quality data analytics and outcomes measurements to drive change.
• Exceptional attention to detail, with the ability to organize and operationalize projects. Ownership and accountable mentality.
• Excellent communication and presentation skills, with the ability to clearly and effectively communicate complex ideas to diverse audiences.
• Ability to work quickly and adjust priorities gracefully.

Compensation and Benefits

The salary range the company expects to pay for this position is between $90,000-$110,000 per year. Full-time employees are also eligible for an annual discretionary bonus. The company provides its employees a competitive benefit package.