Medicare Program Partner

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🔥 2 minutes ago

⛰️ Colorado, Idaho, +4 more states – Remote

⛰️ Colorado – Remote 🥔 Idaho – Remote 🦬 Montana – Remote 🎰 Nevada – Remote ⛷️ Utah – Remote 🦬 Wyoming – Remote

💵 $59 - $91 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🪙 Affiliate Manager

👻 Ghost score 0%

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IMH

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2007

🏗️ Construction

📦 Logistics

🛡️ Insurance

Construction • Logistics • Insurance

IMH is the Groupe IMA entity providing end-to-end housing assistance and post-claim services across France. It operates 24/7 emergency call-taking and rapid-response interventions for home incidents (fires, water damage, electrical faults, locksmithing), offers remote damage expertise and cost estimation, and manages repair-in-kind through a national network of vetted contractors. IMH also runs digital platforms to support project estimation and paid home-service offerings, coordinates large-scale catastrophe responses, and connects insurers, beneficiaries and service providers via its accredited prestataire network.

📋 Description

• Lead and oversee daily market operations of the Medicare Advantage program • Ensure compliance with CMS regulations and internal policies • Develop, implement, and optimize operational strategies supporting enrollment, product development, member services, claims, utilization management, and care coordination • Ensure operational readiness for CMS audits, program reviews, and regulatory changes during the annual product development cycle • Partner with Compliance and Legal teams to operationalize CMS guidance, HPMS memos, and federal/state regulations • Drive improvements in Star Ratings, member experience, quality measures, and operational KPIs • Oversee delegated entity and vendor performance, including contract compliance and reporting • Collaborate with Finance on budgeting, forecasting, and cost management • Foster local market accountability and continuous improvement • Support growth initiatives, new market entry, benefit design changes, and annual enrollment periods • Use data and reporting to identify trends, risks, and operational enhancement opportunities

🎯 Requirements

• Bachelor’s degree • 5+ direct years of Medicare Advantage experience • Relevant experience such as working with CMS audits, STAR ratings optimization, and/or quality improvement initiatives • Background in payer operations, health plans, or value-based care organizations • Knowledge of delegated and vendor management models • Lean, Six Sigma, or other process improvement certification • Ability to work remotely with business travel as-needed • Candidates must reside in an eligible location; employment registration is maintained in Utah, Idaho, Nevada, Colorado, Montana, and Wyoming, while candidates in other locations may be considered • Video interview through Microsoft Teams required, with potential onsite interviews and meetings

🏖️ Benefits

• Annual Pay for Performance (AP4P) Plan • Comprehensive benefits package covering programs supporting wellness, security, connection, and engagement • Fully remote work arrangement • Business travel as-needed

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