Director Medicare Operations

Director of Medicare Operations

This is not a Medicare sales or producer position. It is an operations, compliance, carrier contracting, technology, and team-development role focused specifically on building the organization’s Medicare Supplement capabilities.

About the Organization

The organization provides an alternative to traditional group health benefits through a technology platform that serves brokers and employers. Employees use the platform to shop for individual health plans and enroll directly with the insurance carrier.

The company currently supports ACA and other non-Medicare individual health products. It is now adding a Medicare division and needs an experienced Medicare professional to build the operational infrastructure, compliance framework, carrier relationships, technology solutions, and internal team required to support the new business line.

The person in this position will report directly to Hunter.

Primary Responsibilities

The Director of Medicare Operations will:

• Develop the company’s Medicare Supplement operational model and supporting processes.
• Establish compliant procedures for Medicare-related enrollments, communications, documentation, and agent activity.
• Lead carrier contracting and appointment efforts with Medicare Supplement carriers.
• Evaluate and help select technology solutions that support quoting, enrollment, compliance, reporting, and customer service.
• Build and develop a Medicare operations team of approximately six employees.
• Establish workflows, performance standards, training procedures, and quality controls for the team.
• Work closely with leadership, technology, agency operations, brokers, carriers, and compliance partners.
• Help scale the Medicare division as the company expands its services.
• Ensure the Medicare operation integrates effectively with the organization’s existing ACA and individual health platform.

Ideal Candidate Background

The strongest candidate will have significant experience with Medicare Supplement products and the operational requirements surrounding them.

The organization would prefer someone who has worked for an independent insurance agency, brokerage, field marketing organization, or similar organization where they were involved in developing or expanding a Medicare business.

The person should understand:

• Medicare Supplement products and carrier requirements.
• Medicare-related compliance and operational procedures.
• Carrier contracting, appointments, licensing, and onboarding.
• Agency operations and enrollment workflows.
• Technology platforms used for quoting, enrollment, compliance, and customer management.
• Team development, training, and performance management.
• How to build processes and infrastructure within a growing organization.

Experience helping grow an agency, department, startup, or new division would be highly valuable.

What the Role Is Not

This position is not designed for someone whose Medicare experience has primarily consisted of selling policies directly to consumers.

The successful candidate does not need to be a traditional salesperson or business-development producer. The emphasis is on building and managing the operational foundation behind a Medicare Supplement business, including compliance, carrier relationships, technology, processes, and people.