Lead Insurance Product Manager - Part D/PDP

Humana

1d•$115,200 - $158,400•Remote

About The Position

Humana is seeking an experienced Medicare Part D professional to lead strategy and execution for its standalone Prescription Drug Plan (PDP) portfolio. The role connects Part D strategy to accurate, compliant, and timely execution throughout the product lifecycle, including market and regulatory assessment, bid development, filing, implementation, and annual readiness. The Lead Insurance Product Manager evaluates member, regulatory, financial, market, and operational considerations and provides recommendations that support informed leadership decisions. This is an advanced individual-contributor position with significant independence and no requirement for formal people-management authority. The role leads through subject-matter expertise and influence, establishes methods and priorities for complex work, guides associates and work groups, and strengthens governance, reusable tools, documentation, and shared capability across PDP Product Management. The position leads PDP portfolio strategy and annual bid, benchmark, filing, and readiness activities; interprets CMS guidance and translates policy changes into product requirements and execution plans; assesses feasibility across functions; and supports new Part D opportunities, including CMMI demonstrations and emerging pharmacy programs. It also coordinates State Pharmaceutical Assistance Program (SPAP) requests and implementations, supports accurate member-facing product information, and improves quality and operating processes through controls, automation requirements, root-cause analysis, coaching, and cross-training. The position reports to the Director, Insurance Product Management and serves as the primary CPES lead for PDP product strategy and execution. It partners with teams and leaders across Pharmacy, Part D Strategy, Actuarial, Finance, Regulatory Compliance, Legal, Operations, Marketing, Sales, Digital, Process Improvement & Program Delivery, member communications, and Product Management. This is a remote role with occasional travel to Humana offices for training or meetings. Employees working from home or in a hybrid arrangement must have internet service with at least 25 Mbps download and 10 Mbps upload speeds and a dedicated work area that protects member PHI/HIPAA information. The role follows the annual Medicare Part D and CMS regulatory cycle; certain periods require extended hours and occasional weekend work. The scheduled workweek is 40 hours. The posted annual base salary range is $115,200–$158,400, and the role is eligible for a bonus incentive plan.

Requirements

Bachelor’s degree.
At least 5 years of relevant healthcare, health plan, Medicare, product management, or related experience, including substantial Medicare Part D experience.
Direct experience with standalone Prescription Drug Plans and the Medicare Part D product lifecycle.
Experience leading Medicare Part D product strategy, bids, filings, benefit implementation, or annual readiness activities.
Ability to interpret CMS regulatory, contractual, or operational guidance and translate it into product requirements, decisions, and execution plans.
Demonstrated experience leading complex cross-functional projects, processes, or work groups with minimal instruction.
Ability to exercise independent judgment, analyze complex information, and present clear recommendations and tradeoffs to senior leaders.
Excellent written, verbal, facilitation, and presentation skills.
Ability to work extended hours and occasional weekends during critical CMS, bid, and implementation periods.
Ability to meet the work-at-home internet requirements, when working from home or in a hybrid arrangement: minimum 25 Mbps download and 10 Mbps upload speeds, with a dedicated workspace that protects member PHI/HIPAA information.

Nice To Haves

Deep hands-on experience with PDP bid submission, PBP Section Rx, HPMS, audit exhibits, benchmark, de minimis, rebate reallocation, or desk review activities.
Knowledge of LIS, SPAP, formulary coordination, Part D member materials, and AEP readiness.
Experience with competitive intelligence, CMMI demonstrations, or implementation of new CMS pharmacy initiatives.
Experience developing business requirements for automation, process improvement, product data, or benefit-authoring tools.
Experience creating governance, quality controls, metrics, or reusable operating mechanisms for complex product work.
Experience coaching product professionals or leading work through indirect teams.
Project management, Lean, or related process-improvement certification.

Responsibilities

Lead year-round PDP product strategy and execution, translating enterprise priorities, customer needs, market dynamics, regulatory requirements, and financial considerations into portfolio recommendations.
Analyze competitive, financial, regulatory, operational, and member information—including competitor participation, premiums, deductibles, cost sharing, and formulary positioning—to evaluate opportunities, risks, and tradeoffs.
Recommend new or enhanced benefits, product features, and market approaches, including business rationale, member impact, dependencies, risks, and implementation paths.
Represent PDP Product Management in strategy and leadership forums and communicate recommendations, supporting evidence, tradeoffs, and decisions needed.
Lead PDP strategy and readiness across the annual bid cycle, including benefit design coordination, bid submission readiness, PBP Section Rx and HPMS activities, validation resolution, and cross-functional alignment.
Coordinate benchmark, de minimis, rebate reallocation, desk review, and related PDP activities, clarifying impacts, options, decisions, and accountable owners.
Lead review and resolution of filing questions, validation findings, audit exhibits, and other CMS submission issues; escalate material product risks appropriately.
Establish working plans, governance, decision points, and controls for accurate, timely, and compliant submissions; maintain records of assumptions, decisions, dependencies, risks, status, and ownership.
Provide final product-level review and sign-off for designated PDP submissions and deliverables under established governance.
Interpret CMS guidance and Medicare Part D policy changes and translate them into product implications, requirements, decisions, and downstream impacts.
Lead feasibility assessments across product, regulatory, actuarial, financial, pharmacy, operational, technology, and member-experience considerations.
Distinguish immediate compliance needs from longer-term product opportunities and recommend practical approaches when guidance or operating conditions are ambiguous.
Lead Product participation in new Part D opportunities, including CMMI demonstrations and emerging pharmacy programs, from concept evaluation through implementation.
Identify product, process, control, and decision-right gaps and recommend sustainable solutions using root-cause analysis.
Lead annual PDP readiness from bid approval through AEP and January 1 implementation, coordinating milestones, dependencies, issue resolution, and leadership status reporting.
Partner with Marketing, Sales, Digital, member-material, and operational teams to ensure benefit messaging and product information are accurate, consistent, and understandable.
Provide PDP subject-matter expertise for product data, member materials, digital tools, training, operational processes, and downstream readiness.
Confirm with functional owners that implemented benefits and member-facing information align with approved product decisions and CMS filings.
Assess readiness and product risk using clear evidence, surface issues early, and drive accountable owners toward resolution.
Lead PDP Product support for SPAP requests for information, evaluations, contracting support, and implementations.
Coordinate SPAP product requirements and decisions with state contacts and internal Legal, Compliance, Pharmacy, Operations, Finance, member communications, and implementation partners.
Assess SPAP impacts on premiums, LIS coordination, member cost sharing, communications, systems, and operational processes; clarify scope, decision rights, dependencies, escalations, and material risks.
Establish standards, controls, and reusable tools that improve quality, consistency, and accountability across PDP strategy, filings, and readiness.
Use data, lessons learned, and root-cause analysis to improve processes and reduce recurring defects, rework, and unnecessary manual activity.
Serve as the business subject-matter expert for automation and product-data initiatives, translating Part D rules and user needs into practical business requirements and controls.
Provide functional leadership, coaching, and subject-matter guidance to Product Managers and cross-functional partners without relying on formal authority.
Lead associates and work groups in determining methods, analytical approaches, priorities, and timelines for complex assignments.
Build cross-training, documentation, and backup coverage to share critical knowledge and improve organizational resilience.
Facilitate decisions involving member, regulatory, financial, operational, and market tradeoffs; exercise independent judgment and escalate appropriately.
Bring structure to ambiguous work by defining problems, aligning stakeholders on outcomes, and establishing paths to resolution.
Communicate concise, evidence-based recommendations to working teams, senior leaders, and executive audiences, and build trusted partnerships that support timely decisions and collective accountability.
Lead multiple high-priority workstreams, reprioritize as needed, and balance strategic thinking with hands-on ownership of critical PDP decisions and deliverables.