Product Director - Medicare

The Product Director - Medicare will provide leadership, oversight, coordination and monitoring of workstreams and activities associated with new Medicare product implementations. The Product Director - Medicare will collaborate with internal partners (including but not limited to: Sales and Marketing, Actuarial/Finance, Operations, Enrollment and Claims) to launch new Medicare products and initiatives which meet company goals and objectives.

This position will serve as the subject matter expert "SME" in a fast-paced environment that leads to progressive decision making based on project/program risk, timelines, budget, and on time deliverables. This position requires time management, through communication, agility, organizational excellence, reporting, high degree of Medicare Advantage knowledge, and finally project/program effectiveness. Responsibilities include ensuring that the new Medicare product meets or exceeds regulatory and accreditation requirements for the Centers for Medicare and Medicaid Services (CMS) and NCQA and is responsible for all implementation workstreams associated with the successful launch and operation of Medicare plans.

The Product Director is responsible for ensuring the performance and success of the company's Medicare product launch, performance standards associated with the product and supporting staff. This position is accountable for all service and operational requirements associated with the product and monitors performance to ensure the plan meets corporate performance benchmarks. The position works collaboratively with and reports directly to the Vice President Medicare-Medicaid Integration.

• Play a pivotal role in the oversight of key product implementation workstreams that integrate key activities, timelines, resources, budget, and track the critical path for assigned project(s). Ensure project workstreams meet CMS and EOHHS requirements.
• Manage new product initiatives from concept to implementation and provide ongoing monitoring post-launch.
• Actively leads and directs resources across the organization and contracted with the organization to achieve program and contract goals related to Medicare implementation and integration into operations
• Function as a subject matter expert (SME) leading effective coordination between organization/department process flows, stand-ups, retrospectives, sprint reviews, design, and planning. Serve as primary liaison for Project Team to key project implementation workstreams
• Actively participate in collaborative team environment to educate, coordinate activities, and resolve unique problems with recommended course to action with internal and external partners.
• Support efforts to achieve operational excellence in the Medicare Advantage products.
• Lead and drive cross-functional implementation priorities to yield results. Simultaneous action at varying stages-initiation, follow through, and completion-on a number of different projects.
• Lead and motivate teams on internal and external implementation deliverables. Foster open dialogue within team and build positive team spirit to overcome obstacles.
• Ability to anticipate issues and work toward a solution by building consensus within the project team.
• Facilitate coordination of the project activities between functional areas and work with senior management to define roles and responsibilities of team members.
• Facilitate resolution of conflicts between functional groups and external collaborators while maintaining objectivity.
• Oversees the work of staff responsible for program implementation and oversight. Provides leadership and direction to staff, including performance management oversight and employee development.
• Serves as representative for the product/program on internal and external committees, as assignee
• Other duties as assigned
• Corporate Compliance Responsibility - As an essential function, responsible for complying with Neighborhood's Corporate Compliance Program, Standards of Business Conduct, applicable contracts, laws, rules and regulations, policies and procedures as it applies to individual job duties, the department, and the Company. This position must exercise due diligence to prevent, detect and report unlawful and/or unethical conduct by fellow co-workers, professional affiliates and/or agents

Qualifications

Required:

• Bachelor's Degree and/or equivalent, relevant work experience in Health Care Management in lieu of a degree
• Seven (7) or more years of Medicare experience. Experience is preferred in product management or development roles within the healthcare or managed care industry
• Demonstrated success in leading end-to-end product development lifecycles, from concept to launch
• Strong analytical and strategic thinking skills, with the ability to synthesize complex information, identify trends, and make date driven decisions
• Exceptional communication and collaboration abilities, with the capacity to influence and build relationships with internal and external partners
• Knowledge of relevant regulations requirements within the manage care industry
• Ability to adapt to a fast-paced and dynamic work environment, with the ability to handle multiple priorities effectively
• Excellent quantitative analysis skills, including medical expense budgeting and expense savings
• Strong project management and research skills and ability to ensure adherence to goals and deadlines
• Strong leadership skills that demonstrate integrity and professionalism
• Effective negotiating skills
• Solid knowledge of Medicaid and/or Commercial regulatory requirements/standards
• Ability to lead and manage in a cross-functional environment
• Intermediate to Advanced computer skills required (Microsoft Office suite)
• Ability to travel for work. Must have access to reliable transportation. If using personal vehicle, must have valid driver's license and proof of insurance. Frequency of travel: daily

Preferred:

• Masters degree
• Contract management experience

Neighborhood Health Plan of Rhode Island is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.