VP, Medicare Market Operations – Business Performance

Work from home Full-time role Hiring

Job Description:

Lead enterprise oversight of Medicare market operational and financial performance across multiple geographies.
Drive accountability for membership growth, medical cost performance, quality outcomes, and operating margin.
Translate large-scale operational, financial, and clinical data into strategic insights and market interventions.
Identify emerging trends in medical cost, utilization, risk adjustment, and member engagement and deploy targeted performance improvement strategies.
Partner with finance and actuarial leaders to manage Medical Loss Ratio, administrative cost efficiency and margin improvement.
Align operational priorities across the enterprise to ensure consistent delivery of Medicare strategy at the market level.
Monitor competitive market dynamics, regulatory developments, and demographic trends affecting Medicare markets.
Build and lead a high-performing team responsible for Medicare market analytics, operational strategy, and performance governance.
Foster a culture centered on accountability, transparency, and data-driven decision making.

Requirements:

Bachelor’s degree required; MBA, MHA, MPH, or related graduate degree strongly preferred
15+ years of leadership experience in healthcare or health insurance
Deep experience in Medicare Advantage operations and market performance management
Demonstrated success managing large-scale operational and financial performance in complex, matrixed organizations
Experience driving enterprise performance improvement initiatives using advanced analytics
Strong familiarity with Medicare regulatory, reimbursement, and quality frameworks
Enterprise strategic thinking
Advanced financial and analytical acumen
Executive communication and stakeholder influence
Ability to translate data into actionable business strategy
Proven ability to lead transformation across highly matrixed organizations.

Benefits:

More open positions