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Added 4 mins ago
EC
Team Lead - Daylight (4x10's)
Eaton Corporation
Jonesville, SC
- $29 to $32 USD / hour
Educational Assistance Program, Employee Discounts, and many more!
Added 4 mins ago
Nuclear Operations Technician I / Nuclear Operations Technician II - Oconee Nuclear Station
Duke Energy
Seneca, SC
“Depending upon the desired qualifications of the successful applicant, the hiring manager may elect to fill this position at a higher level within the job hierarchy”.
Added 4 mins ago
Assistant Restaurant General Manager, River House
Spanish Peaks Mountain Club
Bluffton, SC
Assist the General Manager with daily restaurant operations, floor support, special events, and restaurant reservations
Added 5 mins ago
EC
NPI Engineering Manager
Eaton Corporation
Sumter, SC
- $113,000 to $165,000 USD / year
Eaton’s ES AMER ARS division is currently seeking a NPI Engineering Manager. Relocation assistance will be provided for candidates residing outside a 50-mile radius of Sumter, SC!
Added 5 mins ago
Shift Manager $15 to $19 an Hour
McDonald's
MYRTLE BEACH, SC
The Guest Service Department Manager’s responsibilities may include making sure Crew and Managers deliver a great customer experience, that sales promotions are done well, that all service…
Added 5 mins ago
Pharmacy Technician Home Delivery Call Center
Intermountain Health
Columbia, SC
Any lapse or failure to meet these requirements may result in disciplinary action, up to termination, at the hiring manager's discretion.
Added 21 mins ago
Pharmacy Technician Home Delivery Call Center
Intermountain Health
Phoenix, AZ
Any lapse or failure to meet these requirements may result in disciplinary action, up to termination, at the hiring manager's discretion.
Added 21 mins ago
AE
Senior Manager - Application Security Research
American Express
Phoenix, AZ
- $123,000 to $215,250 USD / year
American Express is seeking a highly technical and innovative Senior Manager of Application Security Research to help advance our application security research, vulnerability discovery, and…
Added 35 mins ago
AG
Sales Lead
Acosta Group
ALBUQUERQUE, NM
- $20 USD / hour
Resolve escalated customer issues while following carrier and program guidelines
Added 45 mins ago
PF
Senior Associate, Client Service Onboarding Manager - Pension Risk Transfer
Principal Financial Group
Des Moines, IA
- $55,800 to $87,600 USD / year
As a Senior Associate, Client Service Onboarding Manager, you'll manage the onboarding of assigned Pension Risk Transfer clients, acting as the main liaison throughout the process. This…
Added 51 mins ago
A
Assessment Lead
Avint
Remote, United States
- $150,000 to $165,000 USD / year
…professional, the Assessment Lead will serve as an Avint career manager and guide the professional advancement of junior team…
Added 57 mins ago
AG
Sales Lead
Acosta Group
CHADBOURN, NC
- $20 USD / hour
Resolve escalated customer issues while following carrier and program guidelines
Added 1 hour ago
M
Senior Lead, Skills Assessment & Validation
Microsoft
United States
- $116,900 to $222,600 USD / year
Lead pilots with selected role cohorts and program owners, incorporate learner and manager feedback, and refine designs before recommending broader adoption.
Added 1 hour ago
Pharmacy Technician
Grand St. Paul CVS, L.L.C.
White Bear Lake, MN
Once in role, Technicians are required to complete a rigorous company training program and satisfy all registration, licensing, and certification requirements according to their State’s…
Added 1 hour ago
Pharmacy Technician
Woodward Detroit CVS, L.L.C.
Westland, MI
Once in role, Technicians are required to complete a rigorous company training program and satisfy all registration, licensing, and certification requirements according to their State’s…
Added 1 hour ago
Pharmacy Technician
Woodward Detroit CVS, L.L.C.
Lake Orion, MI
Once in role, Technicians are required to complete a rigorous company training program and satisfy all registration, licensing, and certification requirements according to their State’s…
Added 1 hour ago
Pharmacy Technician
Maryland CVS Pharmacy, L.L.C.
Ashton, MD
Once in role, Technicians are required to complete a rigorous company training program and satisfy all registration, licensing, and certification requirements according to their State’s…
Added 1 hour ago
Pharmacy Technician
CVS Pharmacy, Inc.
Shrewsbury, MA
Once in role, Technicians are required to complete a rigorous company training program and satisfy all registration, licensing, and certification requirements according to their State’s…
Added 1 hour ago
Pharmacy Technician
CVS Pharmacy, Inc.
Plainville, MA
Once in role, Technicians are required to complete a rigorous company training program and satisfy all registration, licensing, and certification requirements according to their State’s…
Added 1 hour ago
Pharmacy Technician
CVS Pharmacy, Inc.
Milford, MA
Once in role, Technicians are required to complete a rigorous company training program and satisfy all registration, licensing, and certification requirements according to their State’s…
Added 1 hour ago
Pharmacy Technician
CVS Pharmacy, Inc.
Gloucester, MA
Once in role, Technicians are required to complete a rigorous company training program and satisfy all registration, licensing, and certification requirements according to their State’s…
Added 1 hour ago
Pharmacy Technician
CVS Pharmacy, Inc.
Holyoke, MA
Once in role, Technicians are required to complete a rigorous company training program and satisfy all registration, licensing, and certification requirements according to their State’s…
Added 1 hour ago
Pharmacy Technician
CVS Pharmacy, Inc.
Holyoke, MA
Once in role, Technicians are required to complete a rigorous company training program and satisfy all registration, licensing, and certification requirements according to their State’s…
Added 1 hour ago
Pharmacy Technician
CVS Pharmacy, Inc.
Holyoke, MA
Once in role, Technicians are required to complete a rigorous company training program and satisfy all registration, licensing, and certification requirements according to their State’s…
Added 1 hour ago
Pharmacy Technician
CVS Pharmacy, Inc.
Danvers, MA
Once in role, Technicians are required to complete a rigorous company training program and satisfy all registration, licensing, and certification requirements according to their State’s…

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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