Vice President, Medicare

Portland, OR, United States

Job Title

Vice President, Medicare

Exemption Status

Exempt

Department

Medicare Administration

Manager Title

Chief Financial Officer

Direct Reports

Director, Medicare

Requisition #

24180

Pay and Benefits

Estimated hiring range $197,000 - $238,500 /year, 15% bonus target, full benefits. www.careoregon.org/about-us/benefits

Posting Notes

This is a hybrid position that will work primarily from home and will need you to go into the downtown Portland office at least 2 days a week.

Job Summary

The Vice President of Medicare is responsible for strategy and execution of the Medicare Advantage line of business. The majority of time is focused on enterprise-wide engagement, with secondary time on business group oversight. Primary duties include strategic planning and operational effectiveness, as well as development and oversight of resources, relationships, and teams. The position will accomplish goals within a matrixed team approach that involves staff across the organization and actively and regularly participates in strategic planning and collaboration.

Essential Responsibilities

Technical/Strategic Leadership

Provides strategic leadership for the Medicare line of business across the organization.

Oversees problem identification, solution development and implementations necessary to ensure the performance of the Medicare line of business.

Develops and leads a governance model that ensures understanding and alignment of the Medicare program across intersecting departments, matrixed relationships, and external parties.

Ensures the development and deployment of reporting and analytics utilized to oversee Medicare’s operations and support strategic efforts.

Ensures internal systems, controls and measures are in place to enhance effective, efficient, and compliant operations.

Identifies performance metrics and ensures the timely and accurate monitoring and reporting of performance against metrics.

Ensures the Medicare program meets all CMS, OHA, contractual and other requirements.

Promotes innovation, process review and continual improvement.

Serves as a sponsor for key projects and initiatives.

Strategic Planning

Leads the development of vision, goals, and strategic plans for the Medicare line of business.

Develops and refines strategic plans in alignment with organizational vision and goals.

Defines operational structure for areas of oversight and approves policies.

Participates in the strategic planning process for the organization.

Maintains an enterprise view while establishing business unit priorities.

Financial/Resource Management

Develops budgets in alignment with strategic planning.

Ensures teams have sufficient resources to perform their work.

Ensures budgets are monitored and managed effectively across areas of oversight.

Approves resource allocations within budget, including people, finances, and timelines; make decisions on exceptions.

Relationship Management

Ensures strategic messages are regularly and effectively relayed to management team and staff; promotes transparency.

Leverages current relationships and forges and leverages new relationships with community partners, provider networks, and other constituents in alignment with organizational direction and priorities.

Collaborates with leaders across the organization in identifying integrated improvement strategies and ensuring meaningful integration.

Represents the organization in external meetings and functions, providing strong leadership presence and effectiveness.

Employee Supervision

Directs team(s) and establishes team direction and goals in alignment with the organizational mission, vision, and values.

Identifies work and staffing models; recruits, hires, and oversees a team to meet work needs, using an equity, diversity, and inclusion lens.

Identifies department priorities; ensures employees have information and resources to meet job expectations.

Leads the development, communication, and oversight of team and individual goals; ensures goals, expectations, and standards are clearly understood by staff.

Manages, coaches, motivates, and guides employees; promotes employee development.

Incorporates guidance from CareOregon equity tools into people leadership, planning, operations, evaluation, budgeting, resource allocation, and decision making.

Ensures team adheres to department and organizational standards, policies, and procedures.

Evaluates employee performance and provides regular feedback to support success; recognizes strong performance and addresses performance gaps and accountability (corrective action).

Performs supervisory tasks in collaboration with Human Resources as needed.

Organizational Responsibilities

Perform work in alignment with the organization’s mission, vision and values.

Support the organization’s commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.

Strive to meet annual business goals in support of the organization’s strategic goals.

Adhere to the organization’s policies, procedures and other relevant compliance needs.

Perform other duties as needed.

Experience and/or Education

Required

Minimum 12 years’ related experience, including 5 years’ experience in managed care or health plan functions

Preferred

Minimum 5 years’ experience in a supervisory position

Leadership experience in a managed care organization or in a position requiring advanced knowledge of Medicare Advantage regulations

Experience with the dual eligible population

Bachelor’s or Master’s degree in health care administration, public policy, business, or a related field

Knowledge, Skills and Abilities Required

Knowledge

Advanced knowledge of Medicare, the Medicare Advantage program and CMS

Strong understanding of managed care and publicly financed health care stewardship principles

Understanding of best practices that drive an environment of continuous improvement

Skills and Abilities

Leadership effectiveness and ability to design and implement constructive change

Highly effective written and verbal communication skills, as well as strong presentation skills

Possess a high degree of initiative and motivation along with the ability to effectively collaborate and plan with departmental leadership and staff, and other stakeholders/customers

Highly effective strategic planning and resource management skills

High degree of diplomacy, credibility, and persuasiveness to consistently cultivate effective working relationships across a matrixed organization; ability to effectively express ideas and gain acceptance

Ability to work effectively with diverse individuals and groups

Ability to learn, focus, understand, and evaluate information and determine appropriate actions

Ability to accept direction and feedback, as well as tolerate and manage stress

Ability to see and hear for at least 6 hours/day

Ability to read, speak clearly, and perform repetitive finger and wrist movement for at least 3-6 hours/day

Working Conditions

Work Environment(s): Indoor/Office Community Facilities/Security Outdoor Exposure

Member/Patient Facing: No Telephonic In Person

Hazards: May include, but not limited to, physical and ergonomic hazards.

Equipment: General office equipment

Travel: May include occasional required or optional travel outside of the workplace; the employee’s personal vehicle, local transit or other means of transportation may be used.

#Li-Hybrid

Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment.

Veterans are strongly encouraged to apply.

We are an equal opportunity employer. CareOregon considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or veteran status.

Visa sponsorship is not available at this time.

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