Program Director, Medicare Member Journey

PROGRAM DIRECTOR, MEDICARE MEMBER JOURNEY (HEALTHCARE)

Work from home (telecommute) within Oregon, Washington, Idaho or Utah 

Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.  

Who We Are Looking For: 

Every day, Cambia’s Medicare Strategy and Performance Team is living our mission to make health care easier and lives better. Responsible for leading Medicare member journey to achieve business targets across Stars, Risk Adjustment and Clinical programs. Primary Medicare business partner for Member Outreach and Engagement team (Marketing), Digital Operations and Product Management teams, Medicare Concierge Outreach Team, Stakeholder Communications team, and enterprise Member Experience Office (MXO) – all in service of making our members’ health journeys easier.  

If you're a motivated and experienced People Leader with Medicare experience looking to make a difference in the healthcare industry, apply for this exciting opportunity today!
 

What You Bring to Cambia: 

Preferred Key Experience:

• Member Experience

• Customer Lifecycle Management

• Customer Engagement

• Member Activation

• Consumer Behavior Analytics

Qualifications and Certifications:  

• Bachelor’s degree in Business Administration or related field (Masters preferred).

• At least 10 years of experience with large program management and execution, preferably in a services or consumer products company

• Prior partnership with marketing or customer experience teams highly desired.

• Previous leadership and people management experience in a matrixed work environment.

• Equivalent combination of education and experience will be considered.

Skills and Attributes (Not limited to):  

• Demonstrated program leadership in a highly matrixed work environment: structuring work, coaching teams, establishing measures for success, and managing to deliverables. 

• Demonstrated people leadership and influence skills, including leading culture change, fostering new ways of working, and driving innovation in practices and solutions. 

• Strong communication and facilitation skills with all levels of the organization including: the ability to resolve complex issues, build consensus among groups of diverse stakeholders, and develop strong delivery partner relationships. 

• Exceptional judgment, problem solving, and analytical skills with experience providing data-driven insights and recommendations. 

• Embraces new opportunities and thrives developing new functional capabilities with high expectations for performance and momentum. 

• Experience leading data-driven, segmented member/client/customer engagement programs from strategy through to execution to deliver against business targets. 

What You Will Do at Cambia (Not limited to):   

Develops cross-cutting program strategy for member journey. Convenes internal partners to create engagement strategy, shared roadmap, and priorities for improving member activation rates and experience measures. 

Leads three core operating pillars through a distributed partnership model: 

Master Plan for Member Outreach 

• Aligns business owners and strategic partners on “one plan” for member outreach to deliver desired member experience and business results. 

• Leads development of member cohorts and segments bringing together business requirements with key activation factors (such as motivation, SDoH, clinical risk). 

• Manages planning processes and forums to ensure integrated plan across outbound/inbound calls, digital channels, and analog materials. 

• Supports development of plan and oversees signature Medicare experience programs and informs outreach themes for the year. 

• Closely partners with leaders in Marketing, Digital, Strategic Communications, Customer Service and Clinical Care Team to develop activation and experience strategies and prioritize work. 

• Business approver of member outreach programs, monitors progress against “one plan”, and works with strategic partners to solve performance gaps. 

Strategic Initiatives 

• Responsible for generating and managing a pipeline of high value initiatives to improve the Medicare member journey and related operations. 

• Facilitates prioritization process with input from business leaders, strategic partners, and MXO Operating Team. 

• Identifies and coaches talent across the enterprise to lead initiatives in a hub-n-spoke model. 

• Partners with initiative leaders to define, design, and implement solutions as Medicare expert and champion. 

• Ensures progress against initiative timelines and deliverables while helping remove roadblocks, escalate needs, and problem solve challenges. 

Continuous Improvement 

• Leads continuous improvement efforts based on patterns or trends in member complaints, questions, and requests (i.e., moving insights to action). 

• Manages weekly member experience forums with data/insight owners and business leads to surface hot spots, determine whether to watch or act now, and ensure follow up on research and action plans. 

• Ensures focus on highest priority fixes based on frontline volume, potential impact, and near-term feasibility using a data-driven approach. 

• Tracks and supports individual member remediation work resulting from voice of the customer and other member surveys to ensure meeting expectations. 

• Coordinates work to determine key drivers of positive / negative member sentiment and proposes larger initiatives to address significant gaps in member experience and expectations. 

General Operations 

• Daily focus on member journey to achieve better member experience and business results.  

• Accountable for measurement, reporting, assessment of team performance against goals and business targets. 

• Creates a single view of funding and resources, manages prioritization of work across member journey operations, and informs budget development and decisions. 

• Determines priorities and supports member experience and activation research activities. 

• Ensures synergies and coordination with Provider Engagement Team to activate attributed membership. 

• Represents Medicare in enterprise portfolio projects and corporate strategic initiatives, as relevant and requested. 

• Prepares executive communications and provides counsel to senior management on Medicare member journey strategy, performance, and related enterprise efforts. 

• Develops team members and participates in talent management activities. 

The expected hiring range for The Program Director, Medicare Member Journey is $130k–$166k, depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 15%.  The current full salary range for this position is $113k Low/ $142k MRP / $185k High

About Cambia

Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care.  Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through.

Why Join the Cambia Team?

At Cambia, you can:  

• Work alongside diverse teams building cutting-edge solutions to transform health care.  
• Earn a competitive salary and enjoy generous benefits while doing work that changes lives.  
• Grow your career with a company committed to helping you succeed. 
• Give back to your community by participating in Cambia-supported outreach programs.  
• Connect with colleagues who share similar interests and backgrounds through our employee resource groups.  

We believe a career at Cambia is more than just a paycheck – and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more.  

In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include: 

• Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits. 
• Annual employer contribution to a health savings account.  
• Generous paid time off varying by role and tenure in addition to 10 company-paid holidays. 
• Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period). 
• Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave). 
• Award-winning wellness programs that reward you for participation. 
• Employee Assistance Fund for those in need. 
• Commute and parking benefits. 

Learn more about our benefits. 

We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb.