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Added 2 mins ago
Program Analyst
CACI
National Harbor, MD · National Harbor
CACI is seeking a Program Analyst to support a DHS IT services contract, focused on managing and tracking contract deliverables, supporting executive-level reporting, and providing…
Added 3 mins ago
GOVERNMENT OPERATIONS CONSULTANT I - 64031350
State of Florida
TALLAHASSEE, FL
…management, and recommends operation changes to the Fiscal Manager, program managers, and staff pertaining to fiscal functions, process and guidance within the bureau. This position reports…
Added 3 mins ago
SO
GOVERNMENT OPERATIONS CONSULTANT II (Expert Witness Team)- 64085509
State of Florida
TALLAHASSEE, FL
- $45,060.08 USD / year
This position is directly supervised by the Manager I of the Expert Witness Office within the Prosecution Services Unit, Office of the General Counsel. Incumbent has the ability to work…
Added 5 mins ago
Property Manager in Port Orange, FL
The Collier Companies
Port Orange, FL
The Collier Companies is seeking a Property Manager to join our team!
Added 5 mins ago
Service Manager, San Jose
Lucid Motors
San Jose, CA
The Service Manager will be responsible for the day-to-day operations of the Lucid Service Center, effectively managing a team of advisors, technicians, and parts staff. The Service Manager…
Added 5 mins ago
MH
Billing Operations Lead - Atlanta
Martenson, Hasbrouck & Simon LLP
Brookhaven, GA
- $100,000 to $120,000 USD / year
Billing Operations: Process Improvement, Systems and Operational Leadership
Added 10 mins ago
JL
Processing Supervisor - 2nd Shift
Jack Link's Protein Snacks
New Glarus, WI
- $65,000 to $80,000 USD / year
Ensure quality protocols are followed and openly communicated with QC and the Plant Manager in order to fix defects and ensure quality standards are consistently met.
Added 13 mins ago
Senior Talent Acquisition Partner
Suffolk
Boston, MA · Herndon, VA · Dallas, TX
…research and analysis, talent market intelligence, and continuous process improvement. The ideal candidate will be an experienced recruiting professional who can effectively influence and…
Added 14 mins ago
Perianesthesia RN Resident
Munson Healthcare
Traverse City, MI
Be Heard: Share your ideas and help shape the way we work through improvement huddles, employee surveys, and town hall meetings
Added 16 mins ago
Senior Product Manager, Value realization
Humana
Frankfort, KY
To help deliver on this mission, we are seeking a Senior Product Manager to drive the delivery of new reporting requirements for Next Best Action (NBA) and to assist with measurement…
Added 17 mins ago
Patient Care Manager
Houston Hospice
Houston, TX
…experienced, compassionate, and results-driven Patient Care Manager (RN) to lead an interdisciplinary team dedicated to providing quality, patient-centered hospice…
Added 19 mins ago
NM
Physical Therapist-Lymphedema/Ortho Hybrid Huntley/Woodstock Full-time
Northwestern Memorial Healthcare
Huntley, IL
- $45 to $60.75 USD / hour
- Full-time
The position includes direct patient care, teaching, participation on appropriate committees and departmental process improvement.
Added 19 mins ago
NM
Outpatient Physical Therapist-Full-time Sign-on Bonus Available
Northwestern Memorial Healthcare
DeKalb, IL
- $45 to $60.75 USD / hour
- Full-time
…opportunities for professional development, mentorship, and program development. Our integration with hospitals and clinics across Northwestern Medicine make it possible for us to serve…
Added 19 mins ago
NM
Outpatient Physical Therapist-Pelvic Health Full-time Sign-on Bonus Available
Northwestern Memorial Healthcare
Naperville, IL
- $45 to $60.75 USD / hour
- Full-time
The position includes direct patient care, teaching, participation on appropriate committees and departmental process improvement.
Added 19 mins ago
NM
Physical Therapist-Huntley Orthopedic Clinic Full-time Days
Northwestern Memorial Healthcare
Huntley, IL
- $45 to $60.75 USD / hour
- Full-time
The position includes direct patient care, teaching, participation on appropriate committees and departmental process improvement.
Added 19 mins ago
NM
Physical Therapist Outpatient Full Time Day Shift Marianjoy
Northwestern Memorial Healthcare
Wheaton, IL
- $45 to $60.75 USD / hour
- Full-time
The position includes direct patient care, teaching, participation on appropriate committees and departmental process improvement.
Added 19 mins ago
NM
Physical Therapist Orthopedic-Full-time
Northwestern Memorial Healthcare
Geneva, IL
- $45 to $60.75 USD / hour
- Full-time
The position includes direct patient care, teaching, participation on appropriate committees and departmental process improvement.
Added 19 mins ago
NM
Outpatient Physical Therapist-Full-time Days Sign-on Bonus Available
Northwestern Memorial Healthcare
Naperville, IL
- $45 to $60.75 USD / hour
- Full-time
The position includes direct patient care, teaching, participation on appropriate committees and departmental process improvement.
Added 19 mins ago
NM
Physical Therapist-Pelvic Health Sign-on Bonus Available
Northwestern Memorial Healthcare
Geneva, IL
- $45 to $60.75 USD / hour
The position includes direct patient care, teaching, participation on appropriate committees and departmental process improvement.
Added 19 mins ago
NM
Outpatient Physical Therapist-Orthopedic Full-time
Northwestern Memorial Healthcare
Warrenville, IL
- $45 to $60.75 USD / hour
- Full-time
The position includes direct patient care, teaching, participation on appropriate committees and departmental process improvement.
Added 19 mins ago
NM
Physical Therapist Outpatient Full Time Day Shift Marianjoy
Northwestern Memorial Healthcare
Wheaton, IL
- $45 to $60.75 USD / hour
- Full-time
The position includes direct patient care, teaching, participation on appropriate committees and departmental process improvement.
Added 19 mins ago
NM
Physical Therapist-Outpatient Full-time Sign-on Bonus Available
Northwestern Memorial Healthcare
Sandwich, IL
- $45 to $60.75 USD / hour
- Full-time
The position includes direct patient care, teaching, participation on appropriate committees and departmental process improvement.
Added 19 mins ago
NM
Outpatient Physical Therapist-Orthopedic Full-time
Northwestern Memorial Healthcare
Bartlett, IL
- $45 to $60.75 USD / hour
- Full-time
The position includes direct patient care, teaching, participation on appropriate committees and departmental process improvement.
Added 19 mins ago
NM
Physical Therapist Schroth/Ortho-Full-time Days Sign-on Bonus Available
Northwestern Memorial Healthcare
Warrenville, IL
- $45 to $60.75 USD / hour
- Full-time
The position includes direct patient care, teaching, participation on appropriate committees and departmental process improvement.
Added 19 mins ago
NM
Outpatient Physical Therapist-Full-time Days
Northwestern Memorial Healthcare
Sycamore, IL
- $45 to $60.75 USD / hour
- Full-time
The position includes direct patient care, teaching, participation on appropriate committees and departmental process improvement.

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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