Program Manager, ACA/Exchange (Dental)

Guardian Life Insurance Company•Boston, NY

6d•Remote

About The Position

As the Program Manager, ACA/Exchange (Dental) , you will support offering our individual Dental Insurance products through the ACA/Exchange channel. The Retail Segment is a growing channel for Guardian. We allow consumers to shop, quote, enroll, and pay for non-medical health benefits directly from us online, through partnerships with brokers and aggregators, and through the ACA/Exchange. Growth in this channel has been accelerated by healthcare reform, evolving consumer preferences, growth of retirees and gig/part-time workforce which has resulted in an influx of new individuals shopping and purchasing their benefits online and through government exchanges. You Are Able to perform strategic analysis, recommendations, and execution of the exit / entry strategy for new exchanges. Well versed in supporting strategic collaboration with internal stakeholders including Regulatory, Actuarial, Operations, IT, Finance, Marketing, and Retail Distribution. Strategic, innovative and collaborative and accustomed to stakeholder level communications. You Will Engage in annual filing process and responsibilities including but not limited to populating Plan and Benefit Templates, Transparency in Coverage templates, determining service area expansion or retraction, coordinating objection reviews and responses, preparation of relevant documents, etc. Participate in weekly, monthly, and ad hoc calls with CMS and state-based exchanges Conduct competitive analysis on pricing, features, and impact of regulatory trends Support weekly reporting on results and insights during open enrollment period Support annual pre-filing process for our individual dental products across all federal and state-based exchanges that we operate in including competitive reviews, preparing state-by-state analysis, prepare and review policy documents prior to DOI filing, prepare and update benefit summaries, Letters of Interest to file for the following plan year, etc. Monitor and project impacts on upcoming federal and state regulations and New exchange enter/exist state analysis and competitive assessment Support Partner Management team during exchange off-season (partner reporting, sales analysis, new opportunity evaluation) and support performance reporting cadence (weekly, monthly, quarterly, annually) Annual refiling (i.e.: comp intel, service area review, rate review, policy review, application submissions, testing) Ensure Guardian is ready for annual open enrollment period and Annual pricing recommendation and evaluation Collaboration across all internal stakeholders (i.e.: Legal, Compliance, State Filing, Customer Care, Payments management and operations) and with external vendors used for policy administrative functions Participating in weekly, monthly, and ad hoc calls with CMS and state-based exchanges and perform strategic analysis, recommendations, and execution of the exit / entry strategy for new exchanges Review and implement regulatory modifications and review and validate Guardian’s Dental Exchange website and manage relationship and collaborate with third party vendors/partner

Requirements

Bachelors degree required
Minimum 3 year’s experience as a program manager or equivalent role
Experience working in the ACA/Exchange marketplace (Healthcare.gov or State-Based Exchanges)
Strong Program Management, analytical and communication skills, including the ability to produce clear supporting documents in PowerPoint, Excel, etc.
Excellent project management and organizational skills, with demonstrated success achieving results through others
General knowledge of insurance product designs (dental products preferred)
Ability to effectively handle multiple priorities
Fosters a high level of teamwork and collaboration between internal and external stakeholders

Nice To Haves

Experience supporting Open Enrollment activities is preferred

Responsibilities

Engage in annual filing process and responsibilities including but not limited to populating Plan and Benefit Templates, Transparency in Coverage templates, determining service area expansion or retraction, coordinating objection reviews and responses, preparation of relevant documents, etc.
Participate in weekly, monthly, and ad hoc calls with CMS and state-based exchanges
Conduct competitive analysis on pricing, features, and impact of regulatory trends
Support weekly reporting on results and insights during open enrollment period
Support annual pre-filing process for our individual dental products across all federal and state-based exchanges that we operate in including competitive reviews, preparing state-by-state analysis, prepare and review policy documents prior to DOI filing, prepare and update benefit summaries, Letters of Interest to file for the following plan year, etc.
Monitor and project impacts on upcoming federal and state regulations and New exchange enter/exist state analysis and competitive assessment
Support Partner Management team during exchange off-season (partner reporting, sales analysis, new opportunity evaluation) and support performance reporting cadence (weekly, monthly, quarterly, annually)
Annual refiling (i.e.: comp intel, service area review, rate review, policy review, application submissions, testing)
Ensure Guardian is ready for annual open enrollment period and Annual pricing recommendation and evaluation
Collaboration across all internal stakeholders (i.e.: Legal, Compliance, State Filing, Customer Care, Payments management and operations) and with external vendors used for policy administrative functions
Participating in weekly, monthly, and ad hoc calls with CMS and state-based exchanges and perform strategic analysis, recommendations, and execution of the exit / entry strategy for new exchanges
Review and implement regulatory modifications and review and validate Guardian’s Dental Exchange website and manage relationship and collaborate with third party vendors/partner