Easter Seals Jobs

Duties & Responsibilities:

• Well-versed on all aspects related to one or more specific Medicare performance areas such as Risk Score Accuracy, Medicare Clinical Programming and Operations, Provider Performance, Medical and Pharmacy Part D cost savings, and Medicare Star Ratings/member experience.

• Active analysis of complex financial reports with a P&L mindset to identify areas of performance improvement opportunity and to make informed business decisions.

• Leverages market and competitive intelligence reporting that summarizes and provides updates on the competitive landscape to help identify new opportunities based on market trends and changing regulations.

• Identifies key member cohorts and opportunities for achieving short- and long-term profitable growth and retention strategies.

• Works collaboratively across lines of businesses, such as finance, clinical, medical economics, operations, risk adjustment, and population health strategy to implement Medicare strategies and initiatives for profitable performance and ensure seamless partnership and alignment across the enterprise.

• Drives innovation and develops solutions to continually improve product performance.

• Leads presentations for on-going management meetings (i.e. monthly operating reviews) and be able to communicate business updates effectively to all levels of leadership.

• Must be able to perform additional duties as assigned

Minimum Qualifications:

• Bachelor's degree from an accredited institution or relevant experience

• Excellent Microsoft Word, PowerPoint, and Excel skills

• Strong understanding of the healthcare industry marketplace, specific to Medicare Advantage

• Self-motivated and driven

• Understands and translates highly complex concepts to a wide range of audience.

• Strong financial, analytic, strategic and problem-solving skills; must be able to successfully facilitate sound business objectives within a regulated industry. Ability to exercise judgment and discretion of sensitive and/or confidential matters.

• Ability to identify areas of opportunity, develop plan of action, communicate effectively, and execute within project timelines

• Exceptional interpersonal, communication and presentation skills

• Strong understanding of the healthcare industry marketplace, specific to Medicare Advantage

• Team player who contributes to creating a positive work environment and willing to pull their sleeves up to get things done with a bias towards action and prototyping towards a solution.

• Proven ability to handle multiple projects simultaneously and adjust to changes quickly while meeting deadlines.

• Demonstrates intellectual curiosity and a desire to continue learning and growing. This means you want to go above and beyond to understand the business context.

Preferred Qualifications:

• Masters degree from an accredited institution

• Extensive knowledge and experience in one or more the following Medicare Advantage performance areas:

• Risk Score Accuracy

• Medicare Clinical Programming and Operations

• Provider performance

• Medical and Pharmacy Part D cost savings

• Medicare Star Ratings/member experience.

Compliance & Regulatory Responsibilities: Noted above.

License/Certification: N/A

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.