CareFirst BlueCross BlueShield · 5 hours ago
Vice President - Medicare Advantage Business (Hybrid)
Reston, VA
Full-time
Hybrid
Senior Level, Lead/Staff
$207K/yr - $311K/yr
12+ years expCareFirst BlueCross BlueShield is seeking a Vice President for their Medicare Advantage Business. The VP will provide strategic direction and leadership for the Medicare Business, ensuring financial stability, growth, and compliance while overseeing operational functions and managing a high-performing team.
Health CareNon ProfitService Industry
No H1B
Responsibilities
Oversee and direct all functions related to operational and technical resources to drive the business objectives for the MA Wrap program as driven by the BCBSA. This will include the delivery of services in support of the plan, management of the relationships with the participating BCBSA Plans, coordination with BCBSA teams supporting the product, and validation of compliance within the function
Align capabilities and technology within the CareFirst overall platform environment, coordinating development needs within the common platform to align to all Medicare Advantage business changes, and to ensure that all necessary MA Wrap capabilities are developed, maintained, and delivered to the BCBSA as agreed upon
Oversee all operational functions whether matrixed within the overall organization or directly owned to deliver and maintain the BCBSA MA Wrap program according to CMS guidelines
Oversees the strategic and the day-to-day activities of the Department, including directing, coaching, and guiding associates to implement departmental, divisional, and organizational mission/goals. Recruits, retains, and develops a high performing team. Evaluates performance of each team member, generates development plans and sets goals within the context of the corporate policies and procedures. Develops annual goals, prepares, monitors, and analyzes variances of departmental budgets to control and appropriately allocate resources
Qualification
Required
Bachelor's Degree in business or related field
12 years of experience and 7 years of increasingly responsible management experience in health care or health insurance, finance, health care setting or related field
Medicare Advantage managed care experience
Experience in at least one of the following: Medicare Advantage Operations, Sales, Medicare compliance or other health plan operations
Excellent written and verbal communication skills, interpersonal and collaborative skills, and the ability to communicate information security and risk-related concepts to technical and nontechnical audiences at various hierarchical levels, ranging from board members to technical specialists
Strategic leader and builder of both vision and bridges, and able to energize the appropriate teams in the organization
Up-to-date knowledge of business and technical trends to include the ability to execute technology and tool automation processes
Up-to-date knowledge of relevant laws, regulatory and security framework requirements
Multistate Medicare Experience, including market strategy, sales, marketing, network management, or medical cost management
Experience in healthcare, especially the Blue Cross Blue Shield healthcare system
Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence
Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging
Must be eligible to work in the U.S. without Sponsorship
Preferred
Master's degree in business or related field
Benefits
Comprehensive benefits package
Various incentive programs/plans
401k contribution programs/plans
Company
CareFirst BlueCross BlueShield
CareFirst. It’s not just our name. It’s our promise.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Ja'Ron Bridges
Interim President and Chief Executive Officer
Doba Parushev
Vice President, Healthworx Ventures
Recent News
2025-10-02
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