Medicare Product Manager

Product Management
200HP Requisition #
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Summary:  Oversee and implement the ongoing management of Medicare plan design and benefit changes as they impact EmblemHealth and CCI operational departments.  Manage multiple Medicare operational processes and functions, including: the bid submission, marketing materials, regulatory mailings and Plan website.
Work closely with Medicare leaders in the design of products, relying on industry research, historical product performance, and marketplace trends.

  • Evaluate the resource needs of the Medicare Product Team, including resources for: the daily marketing material review process, the annual regulatory mailing process, the bid submission process, the benefit documentation process, and participation on corporate and departmental projects as assigned.
  • Assign resources to routine tasks and projects and monitor progress to ensure timely and accurate completion. 
  • Track and report the status of tasks and deliverables, as determined by the Director of Medicare Products. 
  • Coordinate issue management, including: intake, triage, monitoring of issue resolution.
  • Develop resource management tools to schedule work, monitor progress and report status.
  • Manage the tasks and deliverables of the Annual Renewal that are assigned to the Medicare Products Team to ensure timely and accurate completion.  
  • Assist the Director of Medicare Products with: defining the scope, tasks, timeline, deliverables and milestones of the annual Medicare Renewal. 
  • Advise the project team on the intended operational outcome of Medicare strategic and regulatory changes by attending all workgroup meetings.  
  • Collaborate with the Annual Renewal Project Manager to ensure: issues are adequately defined, assigned and tracked to resolution; risks are accurately documented and mitigated.   
  • Manage the annual Medicare bid submission process, including: collaboration with other departments to obtain bid information (i.e. Actuarial, Pharmacy, Provider Data Reporting, Medical Management, Benefits, Sales, Legal, Operations, etc.)  
  • Identify Medicare product enhancements/benefits requiring filing modifications and complete the annual Medicare bid filing and validation. 
  • Enter all bid data, serve as information system superuser and manage the software data entry of all plans for accuracy within designated deadlines; work cross-functionally to ensure timeliness and precision of information.
  • Coordinate and manage quality control activities related to: the Annual Regulatory Mailings, the Annual Bid Submission, benefits and bid documentation, other processes owned/performed by the Medicare Products Team.
  • Document and coordinate the periodic review and update of Operational Policies and Procedures for processes owned/performed by the Medicare Product Team.
  • Develop informational presentations as requested by the Director of Medicare Products to: provide updates, train and/or communicate status pertaining to Medicare Products and the activities of the Medicare Product Team. 
  • Collect, compile and present data as requested in support of the Medicare Products planning process.
  • Regular attendance is an essential function of the job.  Performs other duties as assigned or required.

  • Bachelor’s Degree required
  • 5-8 years relevant experience 
  • Experience in managing Medicare related projects/processes on a large (divisional/enterprise level) scale. 
  • Knowledge of Medicare Managed Care 
  • Knowledge of Health Insurance Operations, including: Customer Service, Enrollment, Benefits, Claims and Enrollment  
  • Microsoft Office Tools including: Outlook, Excel, Word, Powerpoint 
  • Experience with Microsoft Project and Visio a plus 

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