EyeMed - Director

Requisition ID: 789002
Position:Full-Time
Total Rewards: Benefits/Incentive Information

There’s more to EyeMed than meets the eye. EyeMed is the fastest growing managed vision benefits company in the country with consistent double-digit membership growth! Through our commitment to innovation, we’re reimagining the way employers and their employees think about vision care. We want them to see life to the fullest and experience more of what’s best, not more of the same. And if what’s best hasn’t been done yet, it’s our exceptional and passionate employees driving this change. But, our passion for vision isn’t just about vision insurance benefits. Our employees are proud to support and participate in life-altering global and local missions through our partnership with OneSight, a leading not-for-profit organization with a 100% focus on eradicating the world’s vision crisis.

Your family says a lot about who you are. EyeMed is a key member of the Luxottica family of companies, global leaders in the design, manufacture and distribution of fashion, luxury and sports eyewear. In North America, Luxottica is the home to global brands Ray-Ban, Oakley and many top fashion house brands. Our leading retail brands include LensCrafters, Sunglass Hut, Pearle Vision, and Target Optical.

If you’re passionate about driving innovation and change and interested in a career in the optical and insurance industry, EyeMed wants to start the conversation and help provide you a growth-focused opportunity with America’s fastest growing vision benefits company.

GENERAL FUNCTION

The Director of Comprehensive Eye Care Services is responsible for the overall coordination of the Medicaid/Medicare comprehensive eye care benefits and offerings. The Director works with sales and business development leadership to build a comprehensive, sustainable, and scalable medical surgical eye care model and offering within our strategic partner business segment. The Director partners internally with multiple functions to ensure cooperation, communication. The Director will ensure comprehensive government eye care programs are sustainable, scalable, and meet individual state and market requirements.

MAJOR DUTIES AND RESPONSIBILITIES

• Provides leadership and subject matter expertise for government eye care plan designs for new accounts and existing comprehensive eyecare plan designs.
• Leads center of excellence that provides expert support to Account Management, Sales, Implementation, Claims, and other areas of operations to ensure the delivery of timely and accurate comprehensive eyecare plan designs.
• Partners with Medical Director on provider opportunity and medical management topics
• Tracks proper identification and maintenance of Medicaid/Medicare fee schedules for routine and eye medical / surgical services.
• Provides input and expertise in vision services management discussions and influences decisions, with an emphasis on medical benefit plan designs, benefit fee schedules, medical surgical claims analysis and clinical protocol updates and revisions.
• Partners on developing content for provider newsletters and other provider communications regarding government comprehensive eye care programs.
• Assumes additional responsibilities, including special projects, attending association meetings as well as client meetings, TACs/MACs as needed.
• Works with government program implementation team on new programs through go live with clients
• Assists with RFI/RFP responses as a SME in comprehensive eye care benefits
• Works with Data Integrity, Program Integrity and Claims Teams post go live to review claims and ensure accurate plan administration
• Partners in the development of medical/surgical dashboards for medical management as well as underwriting capabilities

BASIC QUALIFICATIONS

• Bachelor's Degree or equivalent work experience
• 10 years’ experience in managed care or product leadership, business development and/or consulting within healthcare or related field
• MS Office Suite proficiency
• Strong consultative problem-solving skills
• Understanding of government segments (Medicare Advantage, Medicaid, Fed Gov)
• Ability to analyze data and develop business insights
• Analytical skills with ability to manage multiple tasks while meeting required deadlines
• Experience managing teams and leading cross-functional teams

PREFERRED QUALIFICATIONS

• Benefits, insurance or healthcare industry experience
• Experience with strategic customers / external clients

Upon request and consistent with applicable laws, Luxottica will provide reasonable accommodations to individuals with disabilities who need assistance in the application and hiring process. To request a reasonable accommodation, please call the Luxottica Ethics Compliance Hotline at 1-888-887-3348 (be sure to provide your name and contact information so that we may follow up in a timely manner).

We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, gender, national origin, social origin, social condition, being perceived as a victim of domestic violence, sexual aggression or stalking, religion, age, disability, sexual orientation, gender identity or expression, citizenship, ancestry, veteran or military status, marital status, pregnancy (including unlawful discrimination on the basis of a legally protected pregnancy or maternity leave), genetic information or any other characteristics protected by law. Native Americans receive preference in accordance with Tribal Law.