Medicare Product Consultant

HealthPartners is currently hiring a Medicare Product Consultant. This role serves as a regulatory subject matter expert for Medicare Part D and leads the management of vended Medicare benefit solutions, including Fitness and Over the Counter (OTC) programs.

The consultant plays a pivotal role in optimizing cost management by evaluating benefit design and vendor performance to ensure financial sustainability and maximize member value. The role also oversees strategic relationships with vendors and partners to deliver seamless, high-quality member experiences.

Reporting to the Manager, Medicare Programs, the consultant will collaborate closely with a small, focused team that includes a Senior Medicare Programs Coordinator

Required Qualifications:

• Bachelor's degree or equivalent years of related work experience.
• 4 years of professional experience in a health plan or managed care setting, with relevant work in Medicare Part D, Medicare Advantage, or other Medicare products
• Strong analytical skills with proficiency in Excel and contract review.
• Demonstrated ability to read, interpret, and summarize complex Part D regulations and policies.
• Excellent internal and external communication and stakeholder engagement abilities.
• Proven history of building and sustaining collaborative relationships across all levels of an organization, including senior leadership and cross-functional teams.

Preferred Qualifications:

• In-depth knowledge of Medicare products, regulations
• Medicare Part D Program experience
• Previous experience with vendor management and/or collaboration.
• Experience with managing Medicare supplemental benefits

Responsibilities:

(50%) - Part D

• Serve as a subject matter expert on Medicare Part D regulations and compliance.
• Monitor changes in legislation and policy affecting Part D.
• Analyze CMS guidance and ensure organizational adherence.
• Support formulary development and benefit design.
• Collaborate with pharmacy teams, compliance, member experience teams and actuarial departments.

• Maintain up-to-date knowledge of the Medicare Part D program and evolving Federal landscape, including evolving formulary design strategies and management, benefit configuration, and reporting standards.

(40%) - Vendor Management & Oversight

• Serve as the primary vendor liaison, negotiating contracts and overseeing execution, amendments, and service delivery.
• Manage vendor onboarding and offboarding processes.
• Led end-to-end RFP process for Medicare services, synthesizing vendor responses across pricing, implementation, service models, and data integration, and evaluating alignment with program goals.
• Maintain and update operational documentation and work instructions to reflect vendor solutions.

(10%) - Compliance & Reporting

• Ensure adherence to CMS regulations and internal compliance standards.
• Prepare and present data-driven insights to leadership and workgroups for program optimization.
• Track and report on vendor performance, eligibility file accuracy, and operational outcomes.

*Job description rankings/percentages are intended to reflect normal averages over an extended period of time and are subject to daily variances. Quality and efficiency standards should at no time be compromised to meet the average expectations expressed above. Job descriptions are subject to change to accommodate organization or department needs.