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Added just now
Assistant Manager
Leeds West Groups
Wichita, KS
An Assistant Store Manager exemplifies professional integrity, strong leadership skills, business acumen, knowledge of automotive industry practices and procedures, and a passion for…
Added just now
Assistant Manager
Leeds West Groups
Topeka, KS
An Assistant Store Manager exemplifies professional integrity, strong leadership skills, business acumen, knowledge of automotive industry practices and procedures, and a passion for…
Added just now
Assistant Manager
Leeds West Groups
Des Moines, IA
An Assistant Store Manager exemplifies professional integrity, strong leadership skills, business acumen, knowledge of automotive industry practices and procedures, and a passion for…
Added 1 min ago
MS
Instructional Assistant - Functional Academic
Metropolitan School District of Warren Township
Indianapolis, IN
- $16.05 USD / hour
…"Instructional Assistants" salary schedule for the designated program, level 1, and is eligible for benefits on the "Support Staff" benefits schedule. Starting pay $16.05 per…
Added 1 min ago
Senior Content Marketing Manager, Institutional
Stellar Development Foundation
NY
…system? Since 2014, the mission-driven team at the Stellar Development Foundation (SDF) has helped fuel the tremendous growth of the Stellar blockchain network, an open-source platform that…
Added 1 min ago
BC
Head Coach, Athletics (Ongoing Applicant Pool)
Bellevue College
Bellevue, WA
- From $10,000 USD / year
- Provide leadership and overall direction for the assigned athletic program, ensuring a positive, competitive, and student-centered team culture.
Added 1 min ago
HA
Housing Program Manager
Housing Authority of the County of Contra Costa
Martinez, CA
- $8,384.7 to $10,191.66 USD / month
Provides technical leadership, coordinates and provides training, counsels and advises staff, and ensures that all team members adhere to departmental program standards and policies as well…
Added 1 min ago
Assistant Director of Financial Aid
Ivy Tech Community College of Indiana
Fort Wayne, IN
Assist with coordination of the college’s federal work study program for on campus and off-site community service positions. Collaborate with non-profit agencies to bring various FWS…
Added 1 min ago
AC
Regional Nurse Manager
Advanced Correctional Healthcare
Mankato, MN
- $100,000 to $105,000 USD / year
Serves as liaison between leadership, clients, and staff.
Added 1 min ago
Controls Program Manager
Johnson Controls Inc.
United States
The Systems Enablement Program Manager provides end-to-end program management for strategic deployment and execution planning initiatives. You will translate improvement priorities into…
Added 1 min ago
AS
University Innovation Alliance Fellow
Arizona State University
United States
- $78,000 to $80,500 USD / year
…mapping, and design thinking through intentional professional development. Working closely with senior student success leaders, Fellows develop strategic insight into institutional…
Added 1 min ago
RN
NORTH ARKANSAS REGIONAL MEDICAL CENTER
Harrison, AR
Access opportunities for continued education, career advancement, and leadership development.
Added 1 min ago
Worldwide Channel Programs, Enablement & Portal Manager
Huntress Labs
United States
…active users, training completion, content engagement, and program participation. Use the data to refine engagement strategy and show the impact of enablement efforts to…
Added 1 min ago
Store Manager
AUTOMOTIVE PARTS HEADQUARTERS
Aitkin, MN
…comprehensive benefits package, and the chance to grow your leadership career with a company that values initiative, teamwork, and…
Added 2 mins ago
Sterile Processing & Distribution Technician II
MaineGeneral Health
Augusta, ME
…business. We do this by offering our teammates a variety of leadership-supported programs and learning and development resources for every stage of their professional development. We know…
Added 2 mins ago
Patient Access Rep - Imaging Dept - 32 hours
MaineGeneral Health
Augusta, ME · Waterville, ME
…business. We do this by offering our teammates a variety of leadership-supported programs and learning and development resources for every stage of their professional development. We know…
Added 2 mins ago
MH
Patient Scheduling Rep - Full-time - OBGYN
MaineGeneral Health
Augusta, ME
- Full-time
…business. We do this by offering our teammates a variety of leadership-supported programs and learning and development resources for every stage of their professional development. We know…
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Physical Therapist (PT) – HomeCare & Hospice
MaineGeneral Health
Augusta, ME
…business. We do this by offering our teammates a variety of leadership-supported programs and learning and development resources for every stage of their professional development. We know…
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Admissions Representative
MaineGeneral Health
Augusta, ME
…business. We do this by offering our teammates a variety of leadership-supported programs and learning and development resources for every stage of their professional development. We know…
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General Maintenance Technician - Per Diem
MaineGeneral Health
Augusta, ME
…business. We do this by offering our teammates a variety of leadership-supported programs and learning and development resources for every stage of their professional development. We know…
Added 2 mins ago
T-Mobile Retail Sales Representative - Corvallis
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Leadership development programs are designed to prepare you for management.
Added 2 mins ago
Operations Manager
GFL Environmental
Byron Center, MI
Assist in development and execution of an operation profit plan that includes:
Added 2 mins ago
Operations Manager
GFL Environmental French
Byron Center, MI
Assist in development and execution of an operation profit plan that includes:
Added 2 mins ago
DONATION PROCESSING ASSOCIATE - BRUNSWICK
Goodwill Southeast Georgia
Brunswick, GA
Safety Compliance: Adhere to all safety procedures, wear required safety equipment, and actively support the safety program.
Added 2 mins ago
Cyber Threat Intelligence (CTI) Analyst
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…incident response, detection engineering, purple team, and leadership stakeholders. Products must distinguish verified observations from analytical judgments and document sources,…

Excellus BlueCross BlueShield

Medicare Segment Manager

Rochester, NY, United States

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Job details

Posting language: English
Posted: Nov 1, 2026

Original job description

Job Description:

Summary:

Under the general direction of the Assigned Management, this position is responsible for supporting Medicare line of business strategy and execution. assuring that all Medicare products and programs are administered according to approved benefit design, regulatory requirements, and strategic objectives for the line of business. The incumbent is accountable for service and operational requirements associated with the line of business. The incumbent will be knowledgeable in all Medicare products, including Medicare Advantage, Medicare Supplement, Part D Prescription Drug Plans, and Dual Eligible products.

Essential Responsibilities/ Accountabilities:

· Develops strategic, operational, and tactical business plans to achieve desired business goals for the Medicare lines of business.

· Understands and evaluates new market opportunities, including building of necessary business cases.

· Conducts evaluation, review, and assessment of various operations for the purpose of identifying root causes of operations problems that contribute to noncompliance and customer

dissatisfaction.

· Consults with team members and stakeholders to streamline system operations and processes to improve business effectiveness and efficiency.

· Plans, develops, and implements special projects, initiatives, and activities to support line of business objectives, product, benefit administration, regulatory requirements, process

improvement, efficiency, and the customer experience.

· Encourages innovation, process improvements and personal development within the functional business areas that support the Medicare products.

· Develops and maintains relationships across the enterprise to promote consistent strategic priorities.

· May serve as a regulatory liaison to NYS, CMS or BCBSA as needed.

· Collaborates with cross functional business and project teams to ensure alignment to line of business objectives, compliance, operational performance and process improvement.

· Ensures cross functional integration of strategies with key internal areas including, but not limited to Marketing, Operational Excellence, Population Health Engagement, Finance, Provider

Contracting, Compliance and Enterprise information Technology. Represents Medicare on related key cross-functional committees and projects to ensure Medicare perspective is being

integrated into strategies of other areas.

· Manages maintenance of business process work item deliverables. Regularly participates in forums and activities to solicit direct customer feedback.

· Reads, interprets, and identifies necessary next steps related to complex government regulations.

· Engages in issue identification as well as problem solving to identify and resolve potential improvement opportunities.

· Serves as a corporate resource for Medicare, providing line of business subject matter expertise to business teams on initiatives and activities that impact the line of business.

· Acts quickly to continuous changes and challenges in the regulatory environment.

· Works closely with other Departments for input and integration. Ensures all perspectives are considered and develops processes and timelines to incorporate planning and execution of

strategies across departments.

· Remains current on evolving market dynamics within the Medicare segment, connects trends to line of business objectives and ensures awareness among key business partners.

· Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct, and leading to the

Lifetime Way values and beliefs.

· Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.

· Regular and reliable attendance is expected and required.

· Performs other functions as assigned by management.

Minimum Qualifications:

· Bachelor’s degree in health administration, marketing, business administration or related field with a minimum of six years progressive health plan operations experience.

· Strong leadership and/or management experience.

· Strong expertise and background dealing with regulatory and accreditation agencies such as NCQA, CMS, Federal & State agencies including DOH, Dept. of Finance Services.

· Remain current on all relevant regulatory requirements.

· Strong process and program management skills, analytical, creativity and initiative in problem solving and solution identification.

· Strong facilitation skills and follow through. Project management experience required.

· Must be a critical thinker and possess effective negotiation skills in dealing with middle and senior management levels.

· Must be self-motivated and a self-starter, able to work independently at times without detailed direction.

· Must possess strong computer skills, including MS Word, Excel and PowerPoint.

· Must possess strong, demonstrated analytical ability, strategic thinking, and creativity as well as a positive attitude, strong work ethic and highly effective communication skills.

· Must be capable of establishing effective relationships with all levels of representation throughout the divisions including senior management to execute cross-divisional initiatives.

Physical Requirements:

· Ability to travel across the health plan service regions as needed.

In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.

Equal Opportunity Employer

Compensation Range(s):

Minimum: $79,068 - Maximum: $142,322

The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position’s minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays.

Please note: There may be opportunity for remote work within all jobs posted by the Excellus Talent Acquisition team. This decision is made on a case-by-case basis.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

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More about this job

Skills

CMS
Regulatory compliance
Process improvement
Business processes
Problem solving
Leadership
Program management
Project management
Negotiation
Work independently
Computer skills
Microsoft Word
Microsoft Excel
Microsoft PowerPoint
Communication skills
Compensation and benefits
Recruitment

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