Founded in 1978,Â Universal Health Services, Inc. (UHS)* is one of the nationâ€™s largest and most respected healthcare management companies, operating through its subsidiariesâ€"acute care hospitals, behavioral health facilities and ambulatory centers nationwide. With more than 74,000 people employed by UHS subsidiaries, UHSâ€™s business strategy is to continue to grow by building or purchasing healthcare facilities across the country, while continuing to strengthen UHSâ€™s well-reputed franchise with itsÂ customaryÂ exceptional service and effective cost control. Our success is driven by a service philosophy based on integrity, competence, compassion, and a responsive management style. UHS has been recognized as a Fortune 500 company and is listed as one of Fortuneâ€™s Most Admired Companies. UHSâ€™s Acute Care Division is comprised of 25 high performing hospitals and several ambulatory care facilities across the nation and prides itself on providing superior patient care.Â
Prominence Health Plan, established in Reno in 1993 as St. Maryâ€™s Health Plan, was acquired in 2014 by Universal Health Services (UHS), one of Fortune Most Admired Companies.Â
In addition to the HMO, Prominence Health Plan also offers Point of Service health plans, a preferred health insurance company that offers Preferred Provider Organization (PPO) health plans, and CDS Group Health, a third-party administrator.
We are a fast-growing, rapidly-changing healthcare organization offering the excitement of a start-up with the support of a Fortune 500 company. We are looking for talented, enthusiastic people to help shape the future of our organization.
Job Summary:Â The Director, Medicare Advantage has accountability for Medicare Advantage operations working cooperatively with internal functional areas and contracted partners.Â The Director will hold product accountability for all aspects of the Medicare Advantage product in all markets and works with the Medicare Compliance Officer to monitor the compliance program.Â The Director will serve as subject matter expert and public spokesperson on all Medicare Advantage matters, serve as the CMS contact person, and participate in the strategy development within Prominence and UHS that will shape the expansion of Medicare Advantage to other markets and additional products. Â The Director will manage the bid process, lead operational strategies and tactics to achieve at least a 4 Star rating, ensure appropriate risk scores, and achieve NCQA accreditation for the Medicare Advantage product. The incumbent will be responsible to identify staffing, logistics, technical, and programmatic resources needed within Prominence to build the necessary capacity and capability within budgetary guidelines.