Product Manager-Medicare

Independent Health Association•Buffalo, NY

16h

About The Position

The Product Manager-Medicare will be responsible for development and/or maintenance for the life cycle of Medicare products. They will continuously assess market needs, consider future technology, competitor products/services and the regulatory environment. The Product Manager will synthesize data from a variety of sources, including profitability, sales projections, client satisfaction levels and operational efficiency, to monitor product performance. They will proactively provide product updates and ensure informed decisions. In addition, they will be a product expert and serve as a liaison among functional areas within the organization and externally for all product-related issues.

Requirements

Bachelor’s degree required. An additional four (4) years of experience will be considered lieu of degree.
Four (4) years of operational healthcare experience with a focus on Medicare programs to include working with government or regulatory agencies such as Centers for Medicare and Medicaid Services (CMS), Department of Health (DOH), Office of Mental Health (OMH), Office of Health Insurance Programs (OHIP), or Office of Medicaid Inspector General (OMIG) required.
Strong understanding of Medicare guidelines, benefit design, and regulatory filing processes.
The ability to synthesize data into useful information and provide recommendations for action.
Strong analytical skills, attention to detail and organizational skills.
Successful project management experience with the ability to develop and execute project plans, manage time effectively and stay organized.
Excellent written and public speaking/group presentation skills for all levels.
Able to present persuasive arguments related to product recommendations both verbally and in writing.
Proven examples of displaying the IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative and Accountable.

Responsibilities

Lead and/or participate in development and documentation of repeatable product development processes, including active participation from Health Care Services, Pharmacy/PBD, Network Contract Management, Actuarial Services/Finance, Market Research, Marketing, Sales, and Product Operations, among others.
Evaluate current products, pricing, membership, financial performance, competitor information, and game theory in the development of an individual, small group, and large group product strategy that aligns with corporate strategy.
Identify risks and opportunities in a timely manner, take initiative and respond quickly to take corrective action and/or maximize opportunities.
Share recommendations, proposals, and status updates with senior leadership for approval.
Work with communications to develop collateral to promote products to targeted customers.
Provide training to internal departments on products and the product portfolio, as well as any changes within these.
Work collaboratively with sales, marketing, operations, and servicing to understand what customers are buying and why.
Understand industry trends and product innovation opportunities to develop new products and features designed to retain, grow, and further engage targeted membership.
Ensure robust QA process is implemented and performed using available resources for regulatory filings, including PBP forms for CMS bid submission, and other required applications and documents
Ensure operational efficiency through utilization of available systems and software to ensure accurate data management and oversight to downstream processes such as collateral development for summary of benefits, annual notice of change, and evidence of coverage.
Provide support and leadership to ensure smooth downstream processes.
Function as subject matter expert in the review of proposed laws/regulations, providing interpretation and understanding of implications for the industry and Independent Health, including recommendations for how best to proceed to ensure compliance and alignment with organizational strategic objectives.
Manage development and maintenance efforts for Medicare policies and procedures to ensure compliance with requirements.
Work with outside vendors, regulatory entities such as CMS, and industry trade associations as needed to support the Medicare product portfolio.