This position provides oversight and leads multiple cross-organizational teams through the product development process within government programs lines of business, including Medicare individual plans, employer group plans, and special needs populations. Key areas of focus include management of market research, competitive analysis, strategic product positioning, and benefit design and pricing. This position is also responsible for coordination and execution of the Medicare product lifecycle process from concept through implementation, and ensuring the life-cycle process is in compliance with State and Federal regulations.
Lead development of Medicare plans, including the market research, competitive analysis, and product and compliance requirements, and the data and research to support decisions. Evaluate expansion opportunities, oversee and execute the annual bid process, and perform enterprise competitive analysis. Work closely with actuarial in the design and analysis of products, relying on industry research, historical product performance, and marketplace trends.
Lead and facilitate the Medicare product lifecycle process to achieve product and line of business goals, and effectively promote senior products and services. Develop and execute the product lifecycle work plan. Monitor activities and progress, and analyzes results to measure effectiveness.
Oversee and execute the annual bid process ensuring timeliness and accuracy, and maintain plan design documentation. Management projects including the implementation of new benefits, benefit changes, service area expansion, and plan consolidation.
Lead and facilitate cross-functional teams to meet overall stakeholder expectations and plan’s objectives. Responsible for planning and scheduling project goals, milestones, deliverables, and reporting progress as well as risks to management stakeholders.
Develop and maintain subject matter expertise related to Medicare Advantage service area expansions, notice of intent to apply, bid and implementation planning. Provide consultation to all internal areas with regard to product designs and capabilities.
Prepare and deliver presentations to management, members, brokers and external audiences to solicit support in the development, implementation or continued monitoring of products with regard to administration, enrollment, claims, benefit utilization, and market acceptance.
Maintain knowledge of state and national government programs, health insurance markets, the reform environment and product trends. Provide leadership and guidance in analyzing sales areas and opportunities in collaboration with the Government Program Sales and Marketing and Communications teams to ensure success.
Responsible for oversight, management, development, implementation, and communication of department programs.
Responsible for hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees. Provide feedback, including regular one-on-ones and performance evaluations, for direct reports.
Develop annual department budgets. Monitor spending versus the planned budgeted throughout the year and take corrective action where needed.
Coordinate business activities by maintaining collaborative partnerships with key departments.
Responsible for process improvement and working with other departments to improve interdepartmental processes. Utilize lean methodologies for continuous improvement. Utilize visual boards and daily huddles to monitor key performance indicators and identify improvement opportunities.
Actively participate as a key team member in Manager/Supervisor meetings.
Actively participate in various strategic and internal committees in order to disseminate information within the organization and represent company philosophy.
Meet department and company performance and attendance expectations.
Perform other duties as assigned.
PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.
Work Experience: Minimum of 5 years of experience working with Medicare programs, preferably within a Health Plan setting. A minimum of 3 years of experience leading a team is required. Project management experience in strategic planning and product development required.
Knowledge: Excellent written and oral presentation skills are required. Effective in fostering communication and collaboration with a variety of people, including different departments within the organization. Strong math skills, including percentages, ratios, statistics, graphing and spreadsheets. Requires the ability to define and prioritize work without direct supervision. Advanced knowledge of Medicare within the health insurance industry. Requires excellent project management skills including time management, coordination with other staff, and resource usage. Requires strong analytical and organizational skills. . Intermediate Computer Skills in a Windows Operating System. Proficient in Microsoft Office Applications. Knowledge of Federal & relevant State legislative & regulatory requirements. Knowledge of health payer operations and customer operations. Strategic planning and business plan development experience. Proficient in Microsoft Office software (Access, Excel, Outlook, PowerPoint, and Word). Solid organizational and time management skills. Ability to work as part of a team with strong relationship building skills.
Building Organizational Talent
Coaching and Developing Others
Operational Decision Making
Passion for Results
Additional Salary Information: Depends on experience
We would all like to believe that the work we do matters. And at PacificSource, our employees know they help people get the healthcare they need. We believe our employees are the key to our company’s success, which is why we extend the same care and consideration to our staff as we do to our customers.
Building on a tradition of exceptional customer service and community involvement that start...ed in 1933, we put a human face on health insurance and benefits administration—every day.
- We are committed to doing the right thing.
- We are one team working toward a common goal.
- We are each responsible for our customers’ experience.
- We practice open communication at all levels of the company to foster individual, team and company growth.
- We actively participate in efforts to improve our many communities-internal and external.
- We encourage creativity, innovation, continuous improvement, and the pursuit of excellence.