This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Director, Supplemental Benefits Operations in the United States.
This role sits within a strategic enterprise growth function focused on shaping and delivering supplemental benefits for Medicare Advantage members. It plays a critical part in defining how benefits are designed, operationalized, and continuously improved to enhance member experience, ensure regulatory compliance, and support business growth. The position operates at the intersection of product strategy, operations, clinical insight, actuarial input, and regulatory oversight, requiring strong cross-functional leadership. You will be responsible for translating benefit strategy into scalable, executable operational processes while ensuring accuracy, quality, and compliance. This is a highly collaborative and visible role that influences enterprise-wide decisions and vendor partnerships. It also requires a strong analytical mindset to evaluate performance, market dynamics, and opportunities for innovation in supplemental offerings.
Accountabilities:- Lead the end-to-end strategy for supplemental benefits within Medicare Advantage, ensuring alignment with enterprise goals, regulatory requirements, and member needs.
- Oversee benefit design, configuration, implementation, and quality assurance to ensure accurate and seamless execution across systems and operations.
- Collaborate with actuarial, clinical, operations, finance, and network teams to ensure benefits are financially sustainable and operationally viable.
- Monitor regulatory changes and ensure full compliance with CMS guidelines and applicable state regulations.
- Manage vendor relationships, including third-party oversight and performance management in accordance with internal governance standards.
- Analyze market trends, competitive landscape, and member needs to identify opportunities for differentiated benefit offerings.
- Define, track, and report performance metrics for supplemental benefits, driving continuous improvement and optimization.
- Support annual enrollment readiness, including training, communications, and operational execution.
- Lead a team of process and project professionals, fostering accountability, innovation, and operational excellence.
- Represent the organization in industry forums, regulatory discussions, and vendor negotiations.
Requirements:
- Bachelor’s degree required; advanced degree (MBA, MPH, or similar) preferred.
- 6–8+ years of experience in health insurance, Medicare Advantage, or supplemental benefits operations.
- Strong background in operational execution, risk management, vendor oversight, and regulatory compliance.
- Proven experience leading cross-functional initiatives and influencing senior stakeholders.
- Deep understanding of CMS regulations and supplemental benefit requirements preferred.
- Strong analytical and problem-solving skills with the ability to evaluate complex data and translate insights into action.
- Excellent communication skills, both written and verbal, with the ability to present to senior leadership and external partners.
- Experience managing projects using structured tools and methodologies, with strong organizational skills.
- Ability to lead teams in a fast-paced, regulated environment with multiple priorities.
- Familiarity with Medicare Advantage products, member engagement strategies, and healthcare operations is a strong advantage.
Benefits:
- Competitive annual salary ranging from $150,000 to $206,300, plus eligibility for bonus incentives based on performance
- Medical, dental, and vision insurance coverage for employees and families
- 401(k) retirement savings plan with company participation
- Paid time off, holidays, volunteer time off, and parental/caregiver leave
- Short-term and long-term disability coverage
- Life insurance and additional optional coverage programs
- Flexible remote work arrangement with occasional travel opportunities
- Professional development and leadership growth opportunities
- Comprehensive well-being programs supporting physical, emotional, and financial health
How Jobgether works:
We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.
We appreciate your interest and wish you the best!
Why Apply Through Jobgether?
Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.
#LI-CL1