Description
LaborFirst is the leader in Care Navigation and advocacy, dedicated to improving outcomes and satisfaction for group plan sponsors and their members. Founded in 2005, we partner with all major national health carriers to serve 450+ clients and over 375,000 Medical and Pharmacy lives across all 50 states. We deliver high-touch solutions that drive value while preserving benefits. RetireeFirst, a LaborFirst solution, provides end-to-end Retiree Benefits Management. In partnership with plan sponsors, brokers, and consultants, we design, implement, manage, and administer Medicare benefits, ensuring a seamless transition and continued support. HealthActive, our solution for self-insured health plans with actives and early retirees, combines one-on-one health advocacy with technology-driven insights to help members successfully navigate their healthcare journey.
RetireeFirst is expanding its national Individual Medicare program to serve retirees seeking alternatives to traditional group Medicare Advantage arrangements. This Director leads operational execution, implementation discipline, and regulatory integrity for the Individual Medicare line of business.
This player coach role translates executive strategy into scalable processes, structured enrollment timelines, and embedded compliance controls across all 50 states. The Director is accountable for operational performance and workforce management but does not carry direct P&L responsibility.
Core Responsibilities
Implementation & Operational Execution
- Design and formalize end to end implementation processes for MAPD and Medicare Supplement products
- Establish structured enrollment timelines, readiness checkpoints, and Open Enrollment execution plans
- Build scalable workflows across enrollment, case management, carrier coordination, and advocacy
- Develop and maintain SOPs governing product configuration, carrier rules, enrollment operations, and internal controls
- Ensure national scalability while maintaining disciplined execution and service standards
Compliance & Regulatory Oversight
- Serve as operational subject matter expert on Individual Medicare compliance requirements
- Ensure adherence to CMS regulations, carrier guidelines, and licensing standards
- Interpret CMS guidance and carrier requirements to enable compliant growth strategies
- Embed compliance checkpoints into implementation timelines and enrollment workflows
- Serve as escalation authority for regulatory interpretation and risk assessment
- Oversee agent licensing and certification tracking to maintain uninterrupted selling capability
- Identify regulatory risk areas and implement proactive safeguards
- Maintain documentation and controls that support confident, compliant scale
Sales & Enrollment Operations
- Oversee end to end enrollment accuracy and execution
- Monitor key metrics including cycle time, error rates, compliance findings, and escalation trends
- Partner in a matrixed structure with Advocacy leadership to support licensed Medicare agents
- Ensure operational readiness for annual Open Enrollment and carrier refresh cycles
Carrier & Platform Management
- Lead operational relationships with national and regional carrier partners
- Oversee carrier onboarding, annual product refresh, and configuration updates
- Serve as escalation point for carrier or platform issues impacting enrollment or member experience
- Optimize exchange and enrollment platforms to improve efficiency, accuracy, and compliance
Team Leadership
- Directly manage 1 to 2 team members while serving as a hands on contributor
- Lead workforce planning, capacity forecasting, and productivity oversight
- Establish accountability standards and reporting cadence
- Influence cross functional stakeholders across Sales, Advocacy, Compliance, and Executive leadership
Requirements
Qualifications
- Active health insurance license required
- Minimum 5 years of experience in the Individual Medicare market including MAPD and Medicare Supplement
- Deep working knowledge of CMS regulations and Medicare compliance frameworks
- Demonstrated experience managing or overseeing teams selling Medicare products to individuals
- Proven experience building structured implementation and enrollment processes
- Experience operating in a multi carrier environment
- Strong analytical, organizational, and risk management capabilities
- Ability to operate effectively in a matrixed organization
Preferred Experience
- Experience with enrollment or exchange platforms such as Sunfire
- Experience with Salesforce.com or similar CRM systems
- Prior ownership of Open Enrollment readiness and agent certification processes
- Experience scaling Medicare operations across multiple states
Summary
LaborFirst is committed to regulatory excellence and operational integrity. We have attained HITRUST r2 certification for our Box and Salesforce platforms and hold full URAC Core Accreditation. With headquarters in Mount Laurel, NJ, and our LaborFirst West facility in Scottsdale, AZ, our award-winning team and services have earned national recognition. We consistently achieve world-class Net Promoter Scores (NPS), have been named on the Philadelphia Business Journal’s Best Places to Work list, and have received multiple industry accolades, including a 2024 and 2025 Gold Stevie Award for Front-Line Customer Service Team of the Year. Connect with us at LaborFirst.com.
Competitive salary
Comprehensive benefits package
401k contribution
Generous vacation time
Opportunity to grow
Fastest 50 Growing Companies in NJ
Must be excluded from OIG/SAM
All qualified applicants will receive consideration for employment without regard to race, age, color, ancestry, national origin, place of birth, religion, sex, sexual orientation, gender identity and expression, military or veteran status, genetic characteristics, or disability unrelated to job performance.