Vice President - Medicare Advantage Business (REMOTE)

Resp & Qualifications PURPOSE: The VP, MA Business provides leadership for the operation of the Medicare Business in cooperation with the Blue Cross Blue Shield Association (BCBSA) and as part of the Service Benefit Administrative Services Corporation (SBP), which is a subsidiary of CareFirst and jointly owned by CareFirst and BCBSA. They will provide strategic direction for the development and expansion of the business, and ensure financial stability, growth, and compliance of the business. The VP will have responsibility for business direction, financial performance, alignment with the BCBSA, product direction, and multi-year strategy necessary to deliver the overall BCBSA MA Wrap strategic plan. Through collaboration with matrix leaders in SBP and across CareFirst (technology, finance, operations, compliance), the BCBSA and BCBSA Plans, and others, the VP will drive effective operations, financial performance, contractual compliance, and quality. ESSENTIAL FUNCTIONS: + 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. SUPERVISORY RESPONSIBILITY: This position manages people. QUALIFICATIONS: Education Level: Bachelor's Degree in business or related field. Experience: 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. Preferred Qualifications : + Master's degree in business or related field Knowledge, Skills and Abilities (KSAs) + 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. Salary Range : $207,360 - $311,040 Salary Range Disclaimer The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements). Department MA Operations Equal Employment Opportunity CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information. Where To Apply Please visit our website to apply: Federal Disc/Physical Demand Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs. PHYSICAL DEMANDS: The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted. Sponsorship in US Must be eligible to work in the U.S. without Sponsorship #LI-SD1 REQNUMBER: 21797

Created: 2026-03-07