Director, Medicare Operations
Health Choice is dedicated to improving the health and well-being of the people and communities we serve.
Health Choice believes in a personal approach to health care right in your community. We built our health care plan around you. Our goal is to give you quality health care, programs, and services to support you on your path to wellness.
Health Choice provides exceptional customer service and culturally competent care through:
- Compassionate and responsive member services team
- Collaboration with community physicians to help members get the health care they need.
- Providing culturally competent health care, including extensive translation and interpretation services
- Health programs to help members and their families stay healthy
Position Purpose: This position directs operational activities for the Steward Health Choice Medicare products across all markets.
- The Medicare Operations Director will develop a strategic plan including structure and staffing to ensure all state and federal Medicare regulatory requirements are met including adherence to CMS templates, formats, timely submissions to HPMS
- This individual will have experience reporting to senior leadership, compliance committees, and the board.
- This position is an individual contributor role responsible for supporting all aspects of the operational Medicare program for all of Steward’s Medicare business
- This position reports directly to the Chief Operations Officer and CEO
- Serves as a first point of contact for all Medicare regulatory matters related to the business
- Works in collaboration with the Director of Medicare Compliance to ensure consistency across all Medicare activities
- This position will have subject matter expertise to assist senior leadership with Medicare service area expansion efforts
- Shall provide operational performance updates to management and senior level professional staff and is accountable for Steward Health Choice Performance and results
- Bachelor’s degree required. Master’s preferred
Years of Experience:
- Four (4) or more years managing Medicare operation program activities, including but not limited to auditing and monitoring as well as reporting to leadership, account management with CMS, etc.
- Knowledge of Medicare rules and regulations and health care operations
- Experience doing a Medicare compliance program build-out / leading a compliance program
- Experience performing proactive oversight and auditing
- Experience in a strategic role, ideally leading and implementing a comprehensive compliance program
- Experience managing multiple projects/tasks
- Proven history of successful results in managing issues and driving strategic program initiatives
Position located in Phoenix, Arizona