Manager, Medicare Operations

CVS Health • Saint Louis Park, MN • 1h ago

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Position Summary

The Manager of Medicare Operations is responsible for designing and implementing enterprise-wide solutions that address business challenges within our Medicare organization for Allina Health | Aetna. This role is pivotal in shaping organizational strategy, ensuring compliance, and enhancing operational effectiveness to maintain our competitive edge in the marketplace. The ideal candidate will partner with business owners to achieve strategic objectives, including profitable growth and improved service delivery.

What you will do

Overseesday-to-dayoperationsoftheorganization'sMedicare programtosupportoperational excellence, market readiness, and member retention.

Supportsmarketteambydevelopingandexecutingoncross-enterprise initiatives thatensure efficient and effective delivery of services.

Conductsquality assurance reviews to ensure year-over-year updates and accuracyin Medicare member materials and resources.

Assesses the development of government program opportunities,developsstrategies, presentsrecommendations,andimplementssolutionstoimproveoveralllineofbusinessperformance.

Works closely with thelocalaccountmanagementandsalesteamsongrowthand retention strategies.

Supportsthe investigation and remediation of operational issues as they arise, serving asthe liaison between the market team and national partners.

Defines& drives process improvement and operationalprojectsincollaborationwithsenior management, stakeholders, and senior individual contributors.

Manage year-over-year AEP readiness activities including support for product and vendor implementations, benefit and material reviews and markettrainings.

Support the annual Medicare bid filing by conducting required analysis,consolidatingcompetitive information, and helping to manage bid tools.

Establish andmonitorkey performance indicators (KPIs) to evaluate the success of programs and initiatives.

Requirements :

3-5 years of experience in health insurance, Medicare, or a related government-sponsored healthcare program.

2+ years of project management, program management, or operational leadership experience.

Demonstrated experience leading cross-functional initiatives and influencing stakeholders without direct authority.

Strong analytical and problem-solving skills with the ability to leverage data to drive business decisions.

Proven ability to plan, execute, and deliver complex projects and operational initiatives.

Excellent written, verbal, and presentation communication skills.

Advanced proficiency in Microsoft Excel and Microsoft Office applications.

Preferred Qualifications

Medicare Advantage operational experience.

Experience supporting AEP readiness, Medicare bid development, or regulatory compliance activities.

Project Management Professional (PMP) certification or equivalent project management training.

Experience using Quickbase or similar workflow/project management platforms.

Experience working with sales, account management, and market leadership teams to support growth and retention initiatives.

Education

Bachelor's degree preferred in Business, Healthcare administration, public health or related field.

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$66,330.00 - $145,860.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments (https://learn.bswift.com/cvshealth-mainland) .

We anticipate the application window for this opening will close on: 09/14/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran - committed to diversity in the workplace.

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