Summary of Position
- Lead Medicare performance management by connecting strategy and execution; and integrating data, insights, and execution across financial, operational, quality, and growth dimensions.
- Translate complex analytics into clear priorities, executive-ready insights, and actionable recommendations to support strategic and operational decision-making.
- Serve as a key partner in the development and execution of Medicare strategy - shaping priorities, investments, and longterm direction.
- Drive performance improvement and remediation through structured governance, performance reporting (KPIs, dashboards), and disciplined execution across functional teams.
- Ensure the Medicare business is financially sound, operationally reliable, compliant and market competitive.
Principal Accountabilities
- Lead Medicare Performance Management & Reporting: define, monitor and evolve Key Performance Indicators (KPIs) and develop enterprise dashboards and scorecards aligned to Medicare segment goals and establish transparent reporting to communicate goals and execution across the organization.
- Drive Performance Improvement & Remediation: conduct gap analyses; identify root causes; partner with functional teams to design, prioritize, and track remediation initiatives with measurable outcomes.
- Develop Executive Insights & Presentations: translate complex analyses into clear, concise executive-level presentations, including risks, opportunities and recommendations.
- Lead Cross-Functional Execution & Governance; chair performance governance forums; align stakeholders; establish priorities; develop project plans and ensure milestone tracking, accountability and delivery of results.
- Provide Strategic Execution Support Across Priority Gaps: flex into high-priority areas requiring additional leadership or analytical support; rapidly assess issues and drive execution to address performance or capability gaps.
- Build Strategic & Prioritization Frameworks: support strategy development through strategic assessments, prioritization frameworks, and structured evaluation of initiatives and investments.
- Support Sales, Product & Competitive Performance Analysis: evaluate sales channel performance, enrollment forecasting, product competitiveness, and market positioning to inform growth and product strategy.
Qualifications Education, Training, Licenses, Certifications
- Bachelor's degree in business, Finance, HealthCare Administration, or related field; master's (MBA) preferred.
- Project Management certification (PMI) preferred.
Relevant Work Experience, Knowledge, Skills, and Abilities
- 10 - 12+ years of progressive experience in healthcare, with increasing scope and responsibility.
- 5+ years of Medicare experience (products, regulations, economics, competitors).
- 4+ years in management consulting or equivalent structured problem-solving environment.
- Deep understanding of Medicare P&L and key performance drivers.
- Experience across Medicare product types (MA, SNP, EGWP, PDP, Med Supp).
- Proven ability to develop and effectively utilize tables, dashboards, and performance scorecards.
- Experience conducting gap analysis, performance diagnostics, and strategic assessments.
- Experience developing prioritization frameworks and business cases.
- Strong financial acumen including P&L tracking and enrollment forecasting.
- Experience leveraging internal and external data sources (e.g., CMS data, trend reports, primary and secondary research) to drive actionable insights.
- Ability to translate complex data into clear, decision-ready insights for executive audiences.
- Proven ability to lead complex, cross-functional initiatives with project plans and milestone tracking.
- Strong communication and storytelling skills; ability to influence at all levels.
- Ability to operate effectively in a matrixed organization without direct authority.
- Experience managing people, processes, or project teams.
- Advanced proficiency in Excel.
- Experience with Access, SQL, or similar data tools.
- Expertise in PowerPoint and executive-level presentation development.
- Enthusiasm for engaging with AI solutions (e.g., Co-Pilot) to enhance and expedite all deliverables.
Additional Information
- Requisition ID: 1000003204
- Hiring Range: $113,400-$210,600
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EmblemHealth
Jun 23, 2026