Think Beyond The Label Jobs

JOB REQUIREMENTS: Description The Manager, Product Development and Product Management is a key influencer and contributor in the Medicaid product portfolio by identifying, implementing, and managing strategic partnerships and external vendors. The Manager collaborates extensively with governmental agencies such as CMS and DHS and other regulators in applicable states. The Manager has managerial responsibility for development, implementation, and ongoing management of assigned products, (in addition to possible expansion areas), within the Medicaid segment, as well as management of direct report(s). The Manager leads contract requirement efforts with clinical and quality requirements. This Manager works with numerous Medica functional areas to determine the market need and feasibility for development of new products, enhancements to existing products, and all aspects of regulatory filings at both the state and federal level. The Manager is responsible for overall market success of the products, oversight of policy document development, timely and accurate federal and state submissions (and meeting of requirements), and benefit structure. The Manager will set, maintain, document and preserve intent of product and plan design. The Manager works closely with market and segment leadership, sales, operations, compliance, legal, network, finance, pharmacy operations, clinical quality, and actuarial, to continuously improve market competitiveness and market position as applicable, communicate and train staff on product details, and ensure proper administration and understanding of product intent. The Manager is subject matter expert on assigned product plan performance, including membership, income, medical loss ratio (MLR) and operating margin, and will work on strategies to improve product performance. Key Accountabilities: Medicaid Products Leadership & Strategy Responsible for analyzing data, evaluating risks, and making informed choices to support the success of the product. Exercises high level of decision making. Supports and influences portfolio strategy with data informed approach. Strong ability to influence and negotiate with internal and external stakeholders. Leads product project teams in the initiation, planning, development and successful delivery of Medicaid product solutions by collaborating with segment leadership and functional leaders across the organization, to identify, document and resolve product-related issues and opportunities for improvement. Drives product intent and acts as a SME on all benefits including pharmacy coverage as appropriate, including interpretation of CMS and other federal and state regulatory guidance and impacts on benefit design. Researches and interprets CMS and other federal and state laws and rules, and develops/ implements appropriate corresponding policies that are in compliance with federal... For full info follow application link. Equal Opportunity Employer including Veterans and Disabled Individuals ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/5848130DC6474AF4