VP, Medicare Market Operations – Business Performance
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:
- Health insurance
- Retirement plans
- Paid time off
- Flexible work arrangements
- Professional development
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