Dual Special Needs Plan VP, BlueCare

About the role

We’re looking for a proven leader with deep expertise in Medicare and Dual Special Needs Plans (DSNP), along with a strong track record of driving financial performance, regulatory compliance, and operational excellence.

Responsibilities

• Strategic Partner Across the Enterprise
• Align Cross-Functional Teams
• Navigate Complex CMS and TennCare/Medicaid Requirements
• Own the Full Profit & Loss for the BlueCare Plus DSNP Business
• Set Strategic Direction for Strong Market Positioning, Member Satisfaction, and Operational Efficiency
• Collaborate with Medicare and BlueCare Leaders
• Align Product Strategy
• Oversee Bid Development and Submission
• Drive Performance Across Risk Adjustment and Stars Initiatives
• Ensure Audit Readiness
• Drive Contract Compliance
• Engage Effectively with CMS and State Partners
• Lead High-Performing Teams
• Advance Network and Revenue Optimization Strategies
• Deliver Sustainable Financial Performance
• Maintain Full Regulatory Compliance
• Drive Measurable Improvements in Quality and Member Outcomes
• Build Strong Partnerships Internally and Externally
• Support Long-Term Growth of the DSNP Line of Business

Requirements

This role requires a proven track record of leadership in Medicare and DSNP, along with a strong background in financial performance, regulatory compliance, and operational excellence. The ideal candidate should have experience navigating complex CMS and TennCare/Medicaid requirements, and a demonstrated ability to lead cross-functional teams and align product strategy.

Qualifications

The successful candidate will possess a Bachelor's degree in Healthcare Administration, Business Administration, or a related field, along with a minimum of 10 years of relevant experience in healthcare management, preferably in Medicare and DSNP. A Master's degree is preferred, and experience in risk adjustment and stars initiatives is highly desirable.

Skills

Adept in AI-enabled transformation, with a strong understanding of its strategic value and responsible adoption. Proven ability to embed AI into decision-making, operations, and team workflows to drive innovation, scale, and measurable business impact.

Benefits

Remote work with occasional travel within Tennessee, including BCBST’s headquarters in Chattanooga. Sponsorship is not available for this role.

Pay

TBD

Schedule

Remote work with occasional travel within Tennessee, including BCBST’s headquarters in Chattanooga.

Benefits

Remote work with occasional travel within Tennessee, including BCBST’s headquarters in Chattanooga. Sponsorship is not available for this role.