Medicaid Product Manager

InnoSoul•Raleigh, NC

5d•Remote

About The Position

The NC Department of Health and Human Services (DHHS) Information Technology Division (ITD) seeks a Pharmacy Benefits Management (PBM) IT Product Manager for the Medicaid Enterprise System (MES) project. This is a 100% remote position open to candidates across the US. The IT Product Manager will be a critical leader within the DHHS Medicaid Enterprise System (MES) Program, championing key departmental strategies to improve citizen health outcomes through clinical and technological innovation. This role provides independent product oversight for NCDHHS Medicaid, specifically focusing on Pharmacy Benefits Management (PBM). The position requires expert knowledge of Medicaid PBM processes, intended outcomes, and pain points. Responsibilities include developing and monitoring Medicaid Managed Care product strategies, collaborating with DHHS divisions and external stakeholders to streamline processes, and creating user stories, technology roadmaps, and customer research aligned with Medicaid initiatives and strategic goals. The IT Product Manager acts as the 'ambassador' between Medicaid business functions and other organizations like IT teams, the NC Medicaid Business Information Analytics Office, DHHS Data Office, Information Technology Division, Privacy and Security Office, Policy Office, General Counsel, and the Office of Procurement, Contracts and Grants. The role involves leading cross-functional activities for Medicaid Program oversight, managing staff, setting priorities, and defining roles to secure resources. Collaboration with Product Owners, Business Leads, and Technical Leads is essential. The position requires in-depth knowledge of healthcare products across segments to meet departmental goals, directing the development and implementation of new product initiatives and enhancements, and providing strategic input to senior decision-makers. Communication of project goals, timelines, and results to stakeholders is key. The role involves determining customer needs through various communication methods, translating them into actionable requirements for the MES PMU, and assessing emerging products and partners for potential value or risk. Training on product knowledge, usage, and implementation will be provided. Performance indicators will be analyzed using database queries, and criteria for testing and product acceptance will be defined. The financial and operational benefits of proposed product capabilities will be discussed, and compliance with policies and procedures will be ensured. The product lifecycle from conception to implementation will be managed. The IT Product Manager is also responsible for the successful development of IT systems supporting the Medicaid program, engaging with business owners to develop strategies for MES modules, and owning the translation and specification of functional requirements. Integral work with MES IT Program Managers and the MES Systems Integrator is required to manage feature and system launches. The Product Manager will evaluate work from Medicaid SMEs, Business and Technical Leads, Data Leads, Engineers, and Architects to ensure delivered functionality meets stakeholder needs. Medicaid/Health Care and/or Managed Care experience is required.

Requirements

Expert knowledge of Medicaid Pharmacy Benefits Management (PBM) processes, roles, and intended outcomes. Required 2 Years
Knowledge of Enterprise IT Systems, system integration principles, and associated change management best practices. Required 7 Years
Has an understanding of CMS' Seven Standards and Conditions and the Medicaid program Required 7 Years
Demonstrated ability to manage multiple priorities and projects, function in a fast-paced moving constantly changing, deadline driven environment Required 7 Years
Proficient use of Microsoft Project, Word, Excel, PowerPoint, Access, and Adobe software Required 7 Years
Skills in persuasion, negotiation, relationship management, conflict resolution, and effective oral and written communication at all levels Required 7 Years
Proven track record of launching successful user-focused products preferably in the enterprise, analytics or healthcare space. Required 7 Years
Previous experience creating business use cases, requirements, and process maps/data flows. Required 7 Years
Experience working in a combination of business analysis, product management, project management and/or software application development. Required 7 Years
Excellent communication skills and attention to detail with specific experience developing, editing, and presenting summaries, reports, and complex in Required 7 Years
Experience handling HIPAA and PII data. Required 7 Years
Medicaid Program knowledge or related HealthCare Information System experience Required 7 Years
Medicaid/Health Care and or Managed Care experience is required.

Nice To Haves

Proven experience and working knowledge of agile development methodologies, environment and tools. Highly desired 7 Years
Experience using or implementing Cloud technologies IaaS, PaaS, SaaS. Highly desired 7 Years
7+ years of experience in product management in a healthcare or government setting Highly desired 7 Years
Managed Care knowledge or experience Required 7 Years
MITA knowledge or experience Required 7 Years

Responsibilities

Leads and directs cross-functional activities that provide effective oversight of Medicaid Programs.
Manages direct and hybrid reporting relationships and staff, sets priorities, establishes accountabilities, and defines roles/responsibilities to secure necessary resources not under direct supervision, while maintaining peak levels of performance and compliance.
Collaborates and develops workgroups around product deliverables with Product Owners, Business Leads, Technical Leads and Management.
Directing the conception, development and implementation of new product initiatives, including current product enhancements.
Provides feedback and input to senior level decision-makers to develop long-range strategic alternatives for product solutions.
Communicate project goals and timelines, next steps and results to team members, project managers and the executive team.
Through a variety of communication/meeting methods, determines the customer's needs, leads product discovery and translates these into detailed and actionable requirements for the MES PMU.
Able to assess emerging products and partners to measure and address their potential value or risk to the department, as well as make recommendations on which new technologies to invest in or leverage.
Provide in-person, conference calls, or virtual trainings on product knowledge, usage and implementation.
Use database queries to analyze performance indicators, evaluate survey data, define successful criteria for testing and product acceptance.
Fluently discuss the financial and/or operational benefits associated with proposed product capabilities.
Ensures compliance with all applicable policies and procedures.
Manages the product lifecycle from conception through implementation.
Performs other duties as assigned.
Engage with the business owners to develop the strategy behind how each MES module will support the business requirements definition.
Own the translation and specification of all functional requirements.
Work integrally with MES IT Program Managers and the MES Systems Integrator to manage the launch of features and systems.
Evaluate and analyze work done by Medicaid SMEs, Business and Technical Leads, Data Leads, Engineers, and Architects to ensure the business requested capability, implemented design, and delivered functionality is successful and useful to the stakeholders.