Director, Group Medicare

Job DescriptionYour RoleThe Group Medicare team oversees all aspects pertaining to the strategy, enrollment growth, day-to-day management, retention, compliance, and financial performance of Blue Shield of California’s Group Medicare membership. The Director, Group Medicare will report to the Senior Director, Medicare Growth. In this role you will be responsible for developing and executing on the strategic growth plan for our Group Medicare product, representing a critical and growing membership base. Accountabilities will include retention, financial targets, Medicare Stars, and Risk Adjustment for client accounts in this product. Another critical accountability will be building and maintaining the operational infrastructure through matrixed relationships to support Medicare Advantage PPO in preparation for a state-wide launch of the product. This role is critical to Medicare and Blue Shield achieving our long-term strategy goals. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.Your WorkIn this role, you will:• Develop and execute short and long-term strategic growth plan for Group Medicare, including meeting sales/retention targets and financial operating income goals• Lead matrix relationships within Blue Shield related to Group Medicare accounts to build infrastructure around the PPO product, including capabilities around member engagement, operations, and utilization management; this includes leading governance process and ongoing oversight of Group Medicare capabilities and overseeing workstreams and deliverables to ensure Blue Shield delivers on Group Medicare quality, membership, and OI outcomes• Manage a team of professionals to ensure the Group Medicare business meets its business goals in a compliant manner• Support Commercial Account Executives who manage overall relationships with accounts and consultants, represent Blue Shield in final round bid interviews and ongoing client meetings to understand their needs and ultimately retain client accounts, may also lead open enrollment meetings for key accounts• Consult with Commercial clients on Medicare line of business to drive member outcomes which result in meeting client’s goals and objectives while achieving corporate goals, and build out specific client outcomes to report-out to show our effectiveness in Medicare Stars and risk adjustment scores• Achieve or exceed Operating Income goals for BSC’s Group Medicare membership• Achieve or exceed operational, quality (Medicare Stars), retention, and risk adjustment goals for client accountsQualificationsYour Knowledge and Experience• Requires a bachelor's degree in business, marketing, communication or equivalent experience• Requires at least 10 years of prior relevant experience including 6 years of management experience• Requires 10 years of experience in Medicare with at least 5 years managing or working with Group Medicare accounts and/or Account Management for Group Medicare accounts at a manager or higher level• Requires experience working on Medicare Advantage products, including the annual bid process• Prior experience working with Medicare Advantage PPO product and membership preferredPay Range:The pay range for this role is: $165,990.00 to $248,930.00 for California.Note:Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.About The TeamBlue Shield of California’s mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our continued commitment to diversity, equity, and inclusion upholds our values and advances our goal of creating a healthcare system that is worthy of our family and friends while addressing health disparities, promoting social justice, and integrating health equity through our products, business practices, and presence as a corporate citizen.Blue Shield has received awards and recognition for being a certified Fortune 100 Best Companies to Work, Military Friendly Employer, People Companies that Care, a Leading Disability Employer, and one of California’s top companies in volunteering and giving. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!Our Values:• Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.• Human. We strive to be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes.• Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.Our Workplace Model:Blue Shield of California is dedicated to making work-life balance a reality. Whether you prefer to work in an office or from home, we understand flexibility is more important than ever. That’s why Blue Shield is a hybrid company, offering you the opportunity to decide where you can do your best and most meaningful work.Two ways of working: Hybrid (our default) and office• Hybrid – In a business unit approved office a few times per year to 3 days per week, on average• Office – In a business unit approved office 4+ days a week, on average. If the role you’re applying for is deemed an “Essential Role,” the company has determined that the role can only be performed in a Blue Shield office or in the field and would require your to meet the office worker classification.Physical Requirements:Office Environment - roles involving part to full time schedule in Office Environment. Due to the current public health emergency in California, Blue Shield employees are almost all working remotely. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.Please click here for further physical requirement detail.Equal Employment Opportunity:External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.