Company Statement

EmblemHealth is one of the nation’s largest not for profit health insurers, serving members across New York’s diverse communities with a full range of commercial and government-sponsored health plans for employers, individuals, and families. With a commitment to value-based care, EmblemHealth partners with top hospitals and doctors, including its own AdvantageCare Physicians, to deliver quality, affordable, convenient care. At over a dozen EmblemHealth Neighborhood Care locations, members and non-members alike have access to community-based health and wellness guidance and resources. For more information, visit emblemhealth.com.

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Director, Employer Segments (Healthcare Product Operations)

🔍 New York, New York

New

📁: Sales

💼: EmblemHealth

📅   : Sep 22, 2026 Post Date

Summary of Position

Responsible for translating, implementing and operationalizing the product strategy across all employer-facing lines of business: Large Group Fully Insured (LG FI), Small Group Fully Insured (SG FI), ASO/Self-Insured, Level Funded in addition to joint / shared administration arrangements and Ancillary products.
Support the organization's strategy to grow FI, Self-Funded and Level Funded membership, modernize its administration platform, compete for joint-administration accounts, and launch innovative large group product capabilities the market expects.
Maintain and enhance the existing employer book, redesign the administration model for scalability and compliance, drive joint administration implementation with TPA and co-carrier partners, support the build and implementation of new ASO capabilities and lead the FI and ancillary product platforms.
Responsible for translating the department’s Employer Segment’s business priorities into market-ready, financially sound and operationally executable product designs and for holding the team accountable for on-time delivery, regulatory readiness and product quality across the full employer book.
Partner with sales leadership in client facing presentations serving as the product subject matter expert who fields questions and articulates technical and operational details in real time.

Principal Accountabilities

Drive product delivery and implementation of the employer segment strategy across LG FI, SG FI, ASO/Self-Insured, Level Funded and Ancillary products. Define the multi-year product roadmap aligned to GM’s P&L priorities, growth targets and competitive positioning.
Lead ASO product management and operations with deep subject matter expertise in self-funded employee benefits. Define ASO standard vs. non-standard product guardrails and value proposition and shape the service model in partnership with the areas that own its components (admin services, reporting, stop loss, care management).
Responsible for benefit design standards and regulatory filing strategy for the employer book. Set medical benefit templates, plan structures and network configurations for LG FI and SG FI. Ensure all employer products are rate-able, DFS compliant, and aligned with actuarial pricing assumptions.
Lead, develop and hold accountable a team (ASO Products, FI & SG Products, Ancillary). Set clear role expectations, provide coaching and development, conduct performance reviews and build a high-performing product team capable of executing across all employer LOBs.
Partner with the GM, Employer Segment and Sales leadership to translate employer market priorities into clear product direction. Support RFP responses, broker strategy and account-level product decisions. Bring product expertise into go-to-market conversations and ensure the Sales team is equipped with competitive, accurate product positioning.
Collaborate on employer product growth efforts. Identify opportunities across ASO and LG expansion, SG retention, and ancillary product to deepen product penetration within the existing employer book, driving greater adoption of ancillary lines alongside the core medical plan in partnership with sales and account management.
Coordinate cross-functionally across Actuary, Legal, Compliance, IT, Network, Operations, Communications and more to move products from design to launch-ready state. Serve as the primary decision-maker and escalation point for employer product issues. Represent the employer product function in executive forums, and regulatory discussions.

Qualifications

Education, Training, Licenses, Certifications

Bachelor's degree in Business, Health Administration, Public Health, Finance or related field required.
Master's degree (MBA, MHA, MPH) strongly preferred.

Relevant Work Experience, Knowledge, Skills, and Abilities

10 – 12+ years of progressive experience in health insurance product management. (Required)
5+ years’ experience at a Director or senior leadership level. (Required)
Deep ASO/self-funded product expertise is required. Candidates must demonstrate hands-on experience designing and managing ASO product platforms, service models, stop-loss structures and employer-specific configurations in a regulated health plan environment. (Required)
Fully Insured product experience across Large Group and/or Small Group markets, including benefit design, ACA compliance, DFS filing requirements and community rating rules in New York. (Required)
Proven experience leading a team of product professionals. Demonstrated ability to hire, develop and hold accountable a team of Leaders or Senior Managers. (Required)
Strong cross-functional partnership skills. Track record of successful collaboration with Actuarial, Sales, Legal, Compliance, Network and Operations functions in a health plan. (Required)
Regulatory knowledge of New York market requirements (DFS, ACA, ERISA, NYS DFS rate filing processes). (Required)
Ancillary product experience (Dental, Vision, Rx). (Preferred)
Exceptional communication skills, both verbal and written. Ability to present product strategy clearly to executive leadership, Sales leadership and external stakeholders. (Required)

Security Disclosure

If you receive a job offer from EmblemHealth, the email will be from “HRTalentAcquisition” with the subject: “Offer of Employment for (job title) – Please respond online.” We will never ask you to join a Google Hangout, buy your own equipment, or pay to apply. We also do not use third-party email services like Yahoo or Gmail.

Pay Disclosure

At EmblemHealth, we prioritize transparency in our compensation practices. We provide a good faith estimate of the salary range for potential hires, which is based on key factors such as role responsibilities, candidate experience, education and training, internal equity, and market conditions. Please be aware that this estimate doesn’t account for geographic differences related to your work location. Typically, new hires may not start at the top of this range, as compensation is tailored to each individual's circumstances. For union positions, salaries will be determined according to the collective bargaining agreement. Join us at EmblemHealth, where your contributions are valued and supported by fair compensation.

EEOC Statement

We value the diverse backgrounds, perspectives, and experiences of our workforce. As an equal opportunity employer, we consider all qualified applicants for employment regardless of race, color, religion, sex, sexual orientation, age, creed, citizenship status, gender identity, pregnancy, marital status, national origin, disability, veteran status, or any other protected characteristic protected by law.

Sponsorship Statement

At EmblemHealth, we are committed to building a diverse and talented workforce. However, we are unable to consider applicants who require, or are likely to require, either before or after hire, visa sponsorship for work authorization in the United States, including but not limited to H-1B, F-1 (STEM OPT), TN, or any other non-immigrant status. Some extremely rare exceptions may apply based on critical business needs.