Director, Sales Operations (Medicare)

Remote Full-time
This role provides strategic direction and oversight for both Medicare Sales Operations and Broker Services, ensuring readiness for sales growth and compliance in the Medicare space. The Director will lead broker support functions, sales operations, and performance management to drive Medicare Advantage (DSNP, FIDE, HIDE, MMP) enrollment while ensuring a seamless experience for brokers, agents, and internal sales teams.

Key Responsibilities:

Medicare Sales Operations:
• Lead the preparation and execution of the Annual Election Period (AEP) and Special Election Periods (SEPs), coordinating efforts across Marketing, Training, Communications, IT, Enrollment Processing, and Sales channels.
• Oversee quality assurance audits for all sales and marketing telephone centers to maintain Medicare compliance and optimize sales performance.
• Develop and execute strategies to enhance Medicare Advantage growth, tracking key metrics such as enrollment volume, lead conversion, and retention.
• Manage sales compensation processing for Medicare brokers and agents, including commission audits, payment submissions, and performance-based incentives.
• Partner with Finance to establish Medicare-specific commission structures and provide regular reporting to sales leadership.
• Ensure Medicare sales operations align with CMS regulations, internal compliance requirements, and industry best practices.
• Oversee workforce management, ensuring effective scheduling and tracking of Medicare sales agent activities.
• Drive continuous improvement in agent engagement, onboarding, and training programs tailored to Medicare Advantage sales.
• Develop and oversee internal and external communications strategies for brokers and Medicare field teams, ensuring alignment with Molina’s Medicare growth objectives.
• Maintain all sales and marketing policy and procedure documents and ensure compliance.
• Manage and maintain broker system of record and day to day operations of onboarding and compensation.

Medicare Broker Services:
• Oversee broker onboarding, credentialing, and certification to ensure Medicare brokers are compliant and ready to sell Molina products.
• Maintain and manage the Medicare broker hierarchy system, ensuring data integrity and accurate reporting on broker performance.
• Oversee broker support operations, ensuring prompt responses to inbound broker inquiries and resolution of issues impacting sales.
• Lead compliance efforts for Medicare broker oversight, ensuring adherence to CMS guidelines and Molina’s internal policies.
• Develop and execute broker engagement strategies, focusing on DSNP growth and maximizing broker-driven enrollments.
• Monitor, analyze, and report broker performance metrics (e.g., enrollments, retention, and disenrollment trends) to identify areas for improvement.
• Collaborate with Medicare marketing teams to enhance broker-led marketing campaigns and ensure messaging aligns with regulatory requirements.
• Provide leadership, mentorship, and training for teams supporting Medicare broker services and sales operations.
• Work cross-functionally with other departments (e.g., Compliance, Finance, Health Plans, and Member Services) to ensure seamless Medicare sales processes.

Qualifications & Skills:
• Education: High School Diploma or GED required; Bachelor’s degree in Business or Healthcare Management preferred.
• Experience:
• 10 years of experience in Medicare sales operations and broker management.
• Strong background in Medicare Advantage (DSNP, FIDE, HIDE, and MMP).
• Experience overseeing AEP/SEP sales execution, broker engagement, and CMS compliance.
• Deep understanding of Medicare Advantage sales distribution models, including broker channels, telesales, and field agents.
• Strong leadership experience managing complex Medicare sales functions.
• Ability to track and analyze broker sales data to optimize performance and retention.
• Advanced Excel skills for data analysis and commission tracking.
• Strong project management and problem-solving abilities.
• Six Sigma certification a plus.

Work Environment & Expectations:
• Ability to maintain a flexible work schedule as needed, especially during AEP and peak Medicare enrollment periods.
• Must comply with CMS, HIPAA, and PHI regulations.
• Maintain regular attendance based on agreed-upon schedules.

Molina Healthcare offers a competitive compensation and benefits package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $135,391 - $275,491 / ANNUAL
• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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