Product Manager - Commercial Operations (Hybrid) - (Non IT)

CareFirst•Baltimore, MD

4d•Hybrid

About The Position

Seeking an experienced and highly motivated Product Manager - Commercial Operations to lead Product Lifecycle implementation and regulatory filing support, including execution of required state and federal submissions such as annual Qualified Health Plan (QHP) filings. The ideal candidate will have experience working with a single source of truth benefits system that drives plan design to downstream systems, including the contractual Schedule of Benefits (SOB), Summary of Benefits and Coverage (SBC), and Broker Benefit Summaries. This role requires deep knowledge of health plan benefit structures, with the ability to analyze benefits in a streamlined, automated manner and translate complex business and regulatory requirements into actionable product specifications and operational deliverables. This position works cross-functionally with Product Strategy, Actuarial, Compliance, Legal, Underwriting, Configuration, Mandates, and IT to support successful annual filings, product implementation, and ongoing product enhancements. Additional responsibilities include conducting benefit audits, validation testing, and operational reviews to identify discrepancies and compliance gaps.

Requirements

Bachelor's Degree in Marketing, Business or related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required.
3 years product analysis, product management or related business experience.
Highly developed analytical skills and must be able to effectively communicate complex marketing and business-related issues to a diverse audience (both written and orally).
Ability to build productive relationships, be effective in individual and group meetings, be skilled in conflict resolution negotiations, and be able to lead and work effectively on cross-functional teams.
Aggressive in desire to produce innovative alternatives and be willing to defend suggestions in varied circumstances.
Proficient in Word, Excel, and PowerPoint.
Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence.
Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.
Must be eligible to work in the U.S. without Sponsorship

Nice To Haves

Experience working with a single source of truth benefits system that drives plan design to downstream systems, including the contractual Schedule of Benefits (SOB), Summary of Benefits and Coverage (SBC), and Broker Benefit Summaries.
Deep knowledge of health plan benefit structures.
Ability to analyze benefits in a streamlined, automated manner.
Ability to translate complex business and regulatory requirements into actionable product specifications and operational deliverables.
Experience working cross-functionally with Product Strategy, Actuarial, Compliance, Legal, Underwriting, Configuration, Mandates, and IT.

Responsibilities

Lead regulatory filing execution by interpreting filing requirements, establishing processes and documentation, and guiding team members to complete product implementation and regulatory filing activities.
Collaborate closely with business leaders to communicate status, escalate risks, and develop plans to achieve business goals.
Develop and maintain commercial market portfolios within the single source of truth system to support accurate, automated benefit grids, SBCs, SOBs, and Plan and Benefit Templates (PBTs).
Analyze benefit and regulatory data and provide strategic recommendations to streamline processes across market segments and jurisdictions, reduce inconsistencies, and improve accuracy.
Translate Product Strategy into detailed benefit design specifications to ensure accurate implementation across downstream systems.
Conduct benefit audits, validation testing, and operational reviews to identify discrepancies and compliance gaps.