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HL
Manager, IT Application Support
Homesteaders Life Company
West Des Moines, IA
- $125,000 to $135,000 USD / year
Application Support Leadership: Leads and develops an Application Support & Delivery team responsible for supporting & maintaining critical business applications and operational processes.…
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Accounting Manager - McDavid Ford of Fort Worth
Asbury
Fort Worth, TX
Learning, Tuition Assistance and Career Development:
Added just now
Enterprise Business Director National
West Publishing Corporation
Remote, United States
Design and refine repeatable national go-to-market plays for common state needs such as public safety, justice operations, economic development, healthcare, and fiscal integrity, and scale…
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Director, Commercial Systems Data Migration Lead
Eagan, MN · NY
You will work with a globally distributed team, manage a significant program delivery and, and serve as the accountable owner of data readiness for go-live, advising senior leadership on…
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Project Manager
Irby Construction Company
Lexington, SC
…pre-construction through closeout. The Project Manager must possess strong leadership, technical, and organizational skills, and be able to direct multiple crews and collaborate with…
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K
Cloud Migration Program Manager
Kforce
Remote, United States
- $80 to $90 USD / hour
Provide end-to-end program leadership for a large-scale enterprise cloud migration and/or data center transformation initiative
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K
Business Analyst
Kforce
Remote, United States
- $80 to $90 USD / hour
Strong stakeholder management skills with the ability to work effectively with plant/operations teams, IT professionals, program leadership, and senior executives
Added 1 min ago
Master Trainer
Irby Construction Company
Lockhart, TX · Cocoa, FL · Lakeland, FL · Richland, MS · Winder, GA · Tulsa, OK · Brawley, CA · Geismar, LA · Lexington, SC
…continuous improvement, operational excellence, and cultural leadership while helping ensure every team member returns home better than when they…
Added 1 min ago
P
Advanced Manufacturing - Technical Project Manager
PACCAR
Chillicothe, OH · Kirkland, WA
- $104,100 to $162,900 USD / year
The Technical Project Manager will provide leadership and direction for the development anddocumentation related to manufacturing readiness for new product and operational programs.…
Added 2 mins ago
Pre-Award Services Manager
East Carolina University
NC
Research, Economic Development and Engagement (REDE), led by the Senior Vice Provost for Research and Innovation, provides strategic leadership for East Carolina University’s research,…
Added 2 mins ago
Operations Supervisor
Old Dominion Freight Line, Inc.
Saint Joseph, MO
Take the next step in your career with a leadership role that puts you at the heart of a fast-paced, dynamic environment. As an Operations Supervisor at Old Dominion Freight Line, you’ll…
Added 2 mins ago
Nursing Support Technician - Medical - FT Nights
Grady Memorial Hospital Corporation
Atlanta, GA
Certificate of completion from an accredited Patient Care Technician (PCT) Program
Added 2 mins ago
Registered Nurse - Cath Lab - FT
Grady Memorial Hospital Corporation
Atlanta, GA
…Additional roles include advocacy, performance improvement, leadership, problem solving, delegation, conflict resolution, and team…
Added 2 mins ago
Asst Dir Ambulatory Nursing
MedStar Health
Washington, DC
Contributes to the development implementation monitoring and management of the site/office-based budget and to support the organizational objectives patient care standards and quality of…
Added 2 mins ago
FP
Director, National Accounts – Albertsons
F&S Produce Company Inc
RIVERSIDE, CA
- $170,000 to $210,000 USD / year
…enterprise mindset. You will coordinate closely with Sales, Operations, Supply Chain, Quality, Product Development, Commercialization, Marketing, Finance, Customer Service, and broker…
Added 3 mins ago
Sr. Database Engineer
Starz Entertainment, LLC
Denver, CO
…platforms. The ideal candidate will serve as a technical advisor to development teams, helping select and implement the right data layer for new services while maintaining the performance,…
Added 3 mins ago
Grievance and Appeals Regulatory Oversight Manager (45238)
Neighborhood Health Plan of Rhode Island
Smithfield, RI
Interprets evolving regulatory requirements and communicates operational impacts and recommendations to leadership.
Added 3 mins ago
B
Seasonal Part-Time Sales Teammate
Buckle
Lafayette, LA
- Part-time
Consistently perform leadership actions and maintain high standards, whether or not the Manager is present.
Added 3 mins ago
B
Floor Leader (Full-Time)
Buckle
Lafayette, LA
- Full-time
…cleaning of facilities). Works directly with the Store Manager and Leadership Team to develop sales, recruit new Teammates and provide…
Added 3 mins ago
MS
Senior Scientist - Physicist
Mission Support & Test Services, LLC (MSTS)
Livermore, CA
- $101,524.8 to $152,297.6 USD / year
MSTS seeks a Senior Scientist / Physicist for the High Energy Density Experiments (HEDE) Team at our Livermore Operations site to lead the design, development, and operational fielding of…
Added 3 mins ago
Manager, Brand & Product Marketing
Perry Ellis International
Miami, FL
…content. Additionally, you will partner directly with Sales Leadership (VPs, Directors, and Key Account Managers) to identify focus styles for each retail channel, ensuring targeted…
Added 4 mins ago
CF
Mid-Level Supervisor Intern ABA - South Bay
Center for Social Dynamics
San Jose, CA · Sunnyvale, CA · Milpitas, CA · Campbell, CA
- $25 to $31 USD / hour
Your First Step Into Clinical Leadership in ABA
Added 4 mins ago
CF
Mid-Level Supervisor Intern - Menlo Park
Center for Social Dynamics
Menlo Park, CA
- $25 to $31 USD / hour
Your First Step Into Clinical Leadership in ABA
Added 4 mins ago
Assistant Facility Security Officer
Amro Fabricating Corporation
Mukilteo, WA
…continuous improvement of the company's industrial security program. Working closely with the Facility Security Officer (FSO), you will help ensure compliance with security requirements,…
Added 4 mins ago
Unit Manager - Production Services
Molson Coors
Fort Worth
5-8 years of progressive experience in supply chain, production scheduling, manufacturing operations, logistics, or related operational leadership roles.

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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