What are the responsibilities and job description for the Operations Manager, Medicare Part D position at Alignment Healthcare?
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most : the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.
The Operations Manager oversees operations related to our Medicare Part D program, including the Medicare Prescription Payment Program, and drive annual readiness and expansion initia-tives. This individual contributor will manage day-to-day operations, optimize workflows, and en-sure compliance with CMS regulations. This role will also collaborate with internal leadership, business owners, PBM partners, and key stakeholders to enhance pharmacy services and im-prove operational efficiencies.
Job Duties / Responsibilities :
1. Responsible for oversight and management of the Medicare Prescription Payment Pro-gram.
2. Implement various programs and initiatives to support Pharmacy department and organi-zational goals. Support development of project plans and optimization of operational workflows.
3. Manage Part D annual readiness and expansion activities. Collaborate with Product team on Part D application and bid submissions to CMS. Support build of pharmacy benefits in PBM system.
4. Manage the development, preparation, and quality control of Part D member materials, including the Annual Notice of Change (ANOC), Evidence of Coverage (EOC), and Sum-mary of Benefits.
5. Resolve issues arising from operations and coordination with internal and external stake-holders and vendors.
6. Work cross functionally to ensure seamless operations and optimal member support.
7. Ensure compliance with regulatory requirements and support compliance program ob-jectives.
8. Develop process documentation, policies and procedures, and training materials.
9. Assist with SOX documentation requirements and audit support.
10. Other duties as assigned.
Job Requirements : Experience :
- Required : A minimum of 5 years related experience in an MAPD plan, PBM, or IPA required
- Preferred : 3 years in a operations management role
Education :
Licensure :
Other :
Essential Physical Functions :
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
2. The employee frequently lifts and / or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
Pay Range : $85,696.00 - $128,543.00
Alignment Health is an Equal Opportunity / Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.
Salary : $85,696 - $128,543
