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# Medicare Perf. Mgmt. & Transformation Dir.

- **Company:** EmblemHealth Inc
- **Location:** New York, NY, United States
- **Experience:** Experienced
- **Salary:** $113,400 - $210,600
- **Contract:** Permanent contract
- **Skills:** Microsoft Access, Microsoft Excel, Artificial Intelligence, Data Integration, Microsoft PowerPoint, Microsoft Copilot, SQL Databases, Perf (Linux), Performance Monitor
- **Published:** November 7, 2026
- **Apply:** https://www.careerbuilder.com/job-details/medicare-perf-mgmt-transformation-dir-new-york-ny--3026782b-3784-40cd-85e8-d8e00185b686

## About the Role

Medicare, Performance Management, Medicare, Financial Operations, Management Strategy, Operational Strategy, Operational Support, Performance Metrics, Performance Analysis, Reporting Dashboards, Education, Training, Licenses, Certifications

 * Bachelor's degree in business, Finance, HealthCare Administration, or related field; master's (MBA) preferred.
 * Project Management certification (PMI) preferred.

Relevant Work Experience, Knowledge, Skills, and Abilities

 * 10 - 12+ years of progressive experience in healthcare, with increasing scope and responsibility.
 * 5+ years of Medicare experience (products, regulations, economics, competitors).
 * 4+ years in management consulting or equivalent structured problem-solving environment.
 * Deep understanding of Medicare P&L and key performance drivers.
 * Experience across Medicare product types (MA, SNP, EGWP, PDP, Med Supp).
 * Proven ability to develop and effectively utilize tables, dashboards, and performance scorecards.
 * Experience conducting gap analysis, performance diagnostics, and strategic assessments.
 * Experience developing prioritization frameworks and business cases.
 * Strong financial acumen including P&L tracking and enrollment forecasting.
 * Experience leveraging internal and external data sources (e.g., CMS data, trend reports, primary and secondary research) to drive actionable insights.
 * Ability to translate complex data into clear, decision-ready insights for executive audiences.
 * Proven ability to lead complex, cross-functional initiatives with project plans and milestone tracking.
 * Strong communication and storytelling skills; ability to influence at all levels.
 * Ability to operate effectively in a matrixed organization without direct authority.
 * Experience managing people, processes, or project teams.
 * Advanced proficiency in Excel.
 * Experience with Access, SQL, or similar data tools.
 * Expertise in PowerPoint and executive-level presentation development.
 * Enthusiasm for engaging with AI solutions (e.g., Co-Pilot) to enhance and expedite all deliverables.

## Description

* Lead Medicare performance management by connecting strategy and execution; and integrating data, insights, and execution across financial, operational, quality, and growth dimensions.
 * Translate complex analytics into clear priorities, executive-ready insights, and actionable recommendations to support strategic and operational decision-making.
 * Serve as a key partner in the development and execution of Medicare strategy - shaping priorities, investments, and longterm direction.
 * Drive performance improvement and remediation through structured governance, performance reporting (KPIs, dashboards), and disciplined execution across functional teams.
 * Ensure the Medicare business is financially sound, operationally reliable, compliant and market competitive.

Principal Accountabilities

 * Lead Medicare Performance Management & Reporting: define, monitor and evolve Key Performance Indicators (KPIs) and develop enterprise dashboards and scorecards aligned to Medicare segment goals and establish transparent reporting to communicate goals and execution across the organization.
 * Drive Performance Improvement & Remediation: conduct gap analyses; identify root causes; partner with functional teams to design, prioritize, and track remediation initiatives with measurable outcomes.
 * Develop Executive Insights & Presentations: translate complex analyses into clear, concise executive-level presentations, including risks, opportunities and recommendations.
 * Lead Cross-Functional Execution & Governance; chair performance governance forums; align stakeholders; establish priorities; develop project plans and ensure milestone tracking, accountability and delivery of results.
 * Provide Strategic Execution Support Across Priority Gaps: flex into high-priority areas requiring additional leadership or analytical support; rapidly assess issues and drive execution to address performance or capability gaps.
 * Build Strategic & Prioritization Frameworks: support strategy development through strategic assessments, prioritization frameworks, and structured evaluation of initiatives and investments.
 * Support Sales, Product & Competitive Performance Analysis: evaluate sales channel performance, enrollment forecasting, product competitiveness, and market positioning to inform growth and product strategy.