Location: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of our Norfolk, VA or Richmond, VA Elevance Health PulsePoint locations.
The Medicare Duals Management Director is responsible for developing and ensuring the implementation of a local market duals strategy, specifically focusing on dual eligible members (Medicare and Medicaid) and serving as a bridge between Medicare and Medicaid Product Development and Duals organizations and the local market on current and desired business performance levels, anticipating short-term business needs and long-term perspectives for success.
How you will make an impact:
Primary duties may include, but are not limited to:
Support the development of a 3 to 5-year Duals product and growth strategy for the Health Plan and lead coordinating and facilitating enterprise product/process innovation and development activities.
Establish performance indicators to monitor Duals' performance.
Monitor and advise senior management about regulatory developments, impending changes, or trends.
Partner with Government Relations and enterprise teams on local policy changes that will drive Duals growth and integration.
Foster state relationships for DSNP, in partnership with the Medicaid President, LTSS leader, and Government Relations.
Attend state DSNP meetings and be the thought leader.
Drive synergy enrollment strategies and tactics.
Research new ventures and prospective revenue expansion opportunities in synergy with growth partners, providers, regulators, legislators, and thought leaders.
Document requirements from Health Plan contracts with states (SMACs) and monitor performance.
Work closely with National Duals team and local Government Relations to support customized Government Relations strategies.
Minimum Requirements:
Requires BA/BS degree in a related field; 10 years of related experience, including 5 years in a leadership role; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences:
MBA preferred.
In-depth knowledge and experience in Medicare or Medicaid and previous experience in large complex matrix organizations strongly preferred.
