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VP, Medicare Market Operations – Business Performance
HumanaVice President overseeing operational performance and strategic execution in Medicare markets for a leading healthcare company. Driving growth, profitability, and member experience through data-driven strategies and team leadership.
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Medicare Advantage operationsfinancial performance managementadvanced analyticsoperational strategyperformance governancedata analysisrisk adjustmentmedical cost performanceutilization managementmembership growth
Soft Skills
leadershipstrategic thinkingexecutive communicationstakeholder influencedata-driven decision makingaccountabilitytransparencyteam buildingperformance improvementtransformational leadership
Certifications & Qualifications
Bachelor's degreeMBAMHAMPH
Industry Keywords
healthcarehealth insuranceMedicare marketregulatory frameworksreimbursementquality frameworksoperational performancematrixed organizationsdemographic trendscompetitive market dynamics
About the role
Key responsibilities & impact- Lead enterprise oversight of Medicare market operational and financial performance across multiple geographies.
- Drive accountability for membership growth, medical cost performance, quality outcomes, and operating margin.
- Translate large-scale operational, financial, and clinical data into strategic insights and market interventions.
- Identify emerging trends in medical cost, utilization, risk adjustment, and member engagement and deploy targeted performance improvement strategies.
- Partner with finance and actuarial leaders to manage Medical Loss Ratio, administrative cost efficiency and margin improvement.
- Align operational priorities across the enterprise to ensure consistent delivery of Medicare strategy at the market level.
- Monitor competitive market dynamics, regulatory developments, and demographic trends affecting Medicare markets.
- Build and lead a high-performing team responsible for Medicare market analytics, operational strategy, and performance governance.
- Foster a culture centered on accountability, transparency, and data-driven decision making.
Requirements
What you’ll need- Bachelor’s degree required; MBA, MHA, MPH, or related graduate degree strongly preferred
- 15+ years of leadership experience in healthcare or health insurance
- Deep experience in Medicare Advantage operations and market performance management
- Demonstrated success managing large-scale operational and financial performance in complex, matrixed organizations
- Experience driving enterprise performance improvement initiatives using advanced analytics
- Strong familiarity with Medicare regulatory, reimbursement, and quality frameworks
- Enterprise strategic thinking
- Advanced financial and analytical acumen
- Executive communication and stakeholder influence
- Ability to translate data into actionable business strategy
- Proven ability to lead transformation across highly matrixed organizations.
Benefits
Comp & perks- Health insurance
- Retirement plans
- Paid time off
- Flexible work arrangements
- Professional development