Medicare Program Manager

We have an opportunity to join the Alliance as the Medicare Program Manager in the Medicare Administration Department.

WHAT YOU WILL BE RESPONSIBLE FOR

Reporting to the Medicare Operations Director, this position:

• Performs program planning and design in support of the development and implementation of the Alliance’s Medicare Dual Special Needs Plan (D-SNP) Program and performs ongoing operational program management
• Works collaboratively with all Alliance departments to ensure successful implementation and ongoing management of the D-SNP Program
• Engages with external stakeholders and provides operational support and relationship management for vendor-delivered programs with a focus on quality, accessibility, sustainability, and integration within the Alliance

ABOUT THE TEAM

The Medicare Administration team at the Alliance is small but mighty! Consisting of just a handful of talented and dedicated individuals, this team works cross-functionally to accomplish goals and objectives in support of building out and managing the Alliance's first D-SNP program, effective January 1, 2026. This team is dynamic and flexible, and values collaborative brainstorming, being thought partners for one another, and having a free exchange of ideas for best results and outcomes.

THE IDEAL CANDIDATE

• Proven track record of executing effective business strategies with the ability to execute and deliver results for Medicare Advantage and/or D-SNP programs
• Some experience with the Medicare enrollment process and familiarity with CMS guidelines and turnaround times related to enrollment
• Comprehensive program planning and development, management, and evaluation skills.
• Demonstrated leadership skills with the ability to influence and motivate team members and peers to achieve program goals and objectives
• Demonstrated skill in thinking critically, with the ability to interpret complex Medicare requirements and implement them into business operations
• Champion change management to adopt new program, policies processes for seamless integration with current operations
• Excellent project management and interpersonal skills with emphasis on collaboration
• Excellent written and verbal communication and presentation skills
• Master’s degree in Business, Health Administration, Public Policy or a related field
• Experience working with Medi-Cal products preferred

WHAT YOU WILL NEED TO BE SUCCESSFUL

To read the full position description and list of requirements click here.

• Knowledge of:
• The methods and techniques of Medicare Advantage or D-SNP implementation and/or operational program management
• The methods and techniques of Medicare product implementation and/or management
• The principles and practices of program development, implementation, management, and evaluation
• Complex practices, issues, and theoretical principles related to Medicare Advantage or D-SNP, including the market and regulatory environment
• State and Federal legislative processes
• Ability to:
  • Work effectively with cross-functional teams and build strong relationships with stakeholders
  • Act as a technical resource and explain complex laws, regulations, processes, and programs related to areas of responsibility
  • Demonstrate strong analytical skills, accurately collect, manage, and analyze data, identify issues, offer recommendations and potential consequences, and mitigate risk
  • Identify, discuss, evaluate, and resolve complex and unusual problems in a timely manner
  • Manage multiple projects simultaneously, organize work, and achieve goals and timelines
• Education and Experience:
  • Bachelor’s degree in Business, Health Administration, Public Policy, or a related field
  • A minimum of eight years of experience in a managed care setting which included a minimum of three years of program/project management experience and one year of Medicare-Advantage and/or D-SNP experience (a Master’s degree may substitute for two years of the general managed care experience); or an equivalent combination of education and experience may be qualifying

OTHER INFORMATION

• We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams.
• While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.
• In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.

The full compensation range for this position is listed by location below.

The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).

Typical areas in Zone 1: Bay Area, Sacramento, Los Angeles area, San Diego area

Typical areas in Zone 2: Fresno area, Bakersfield, Central Valley (with the exception of Sacramento), Eastern California, Eureka area