Sr. Director, Health Plan Product

Lumeris

97d • $175,300 - $249,100

About The Position

At Lumeris, we believe that our greatest achievements are made possible by the talent and commitment of our team members. That's why we are actively seeking talented and collaborative individuals who are passionate about making a difference in the healthcare industry. Join us today as we strive to create a system of care that every doctor wants for their own family and become part of a community that values its people and empowers you to make an impact. The Sr. Director, Health Plan Product is responsible for leading the design and strategy of our Medicare Advantage plan offerings, leveraging industry relationships, competitive intelligence, and deep knowledge of market trends. This role is accountable for developing and executing benefit designs that align with organizational objectives, revenue models, and regulatory requirements while ensuring sustained competitiveness in the marketplace. The Senior Director will collaborate cross-functionally with analytics, operations, network, and sales teams to ensure successful plan design and implementation. This role will additionally partner with Compliance, Legal (particularly for new market expansions), as well as Actuarial and Finance teams.

Requirements

• Bachelor’s degree in Business, Finance, Healthcare Administration, or related field (or equivalent experience).
• 15+ years of experience in Medicare Advantage plan design, product strategy, or related health plan leadership roles.
• Minimum 7 years of progressive leadership experience within a health plan or payer organization.
• Proven track record designing competitive health insurance products in large and complex markets.
• Strong understanding of CMS regulations, Medicare Advantage revenue models, and benefit design strategy.
• Exceptional analytical and strategic thinking skills with the ability to translate data into actionable strategies.
• Strong executive presence with excellent communication and relationship management skills.
• Demonstrated experience managing teams/staff, with responsibility for coaching, development, and performance management.

Nice To Haves

• Leadership experience within a large national or regional health plan/payer, including Tier 1 market exposure.
• Experience with both strategic product development and operational plan execution.
• Advanced degree in Business or Healthcare Administration.

Responsibilities

• Lead the strategic development of Medicare Advantage products, using data-driven insights and competitive market analysis.
• Monitor industry trends, competitor offerings, and regulatory changes to ensure our plans remain market-leading and financially sound.
• Partner with actuarial and finance teams to model plan designs, ensuring alignment with revenue, growth and margin goals.
• Translate complex market and financial data into actionable benefit design strategies.
• Develop annual bid strategies and oversee the plan design process to meet CMS bid submission deadlines.
• Maintain strong relationships with industry stakeholders and regulatory agencies to anticipate and adapt to market shifts.
• Collaborate closely with cross-functional partners, including analytics, network, operations, compliance, and marketing.
• Provide leadership and direction to assigned team members, fostering professional growth and accountability, and a culture of innovation.
• Manage and develop direct reports (e.g., Product Strategist), ensuring effective utilization of staff resources, coaching, and professional development.
• Ensure product designs meet compliance, quality, and member experience objectives.
• Oversee benefit vendor partnerships by leading vendor selection processes, negotiating contract terms, and collaborating with operations teams to ensure performance standards are consistently achieved.
• Drive initiatives to identify, evaluate, and execute expansions into new markets and product offerings.
• Present to diverse internal and external stakeholders on industry developments impacting Medicare Advantage.

Benefits

• Medical, Vision and Dental Plans
• Tax-Advantage Savings Accounts (FSA & HSA)
• Life Insurance and Disability Insurance
• Paid Time Off (PTO, Sick Time, Paid Leave, Volunteer & Wellness Days)
• Employee Assistance Program
• 401k with company match
• Employee Resource Groups
• Employee Discount Program
• Learning and Development Opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: Bachelor's degree
• Number of Employees: 1,001-5,000 employees