Company Statement

For the last 80 years, EmblemHealth has been taking care of New York’s heart and soul, its people. Today, health care is more complex than ever. That’s why we’re at the forefront of change. We work alongside our customers to offer access to high-quality, affordable care, help navigate the health care experience, and make good health achievable; because everyone deserves to be taken care of. We deliver on our mission every day by living our values with our colleagues, members, clients and partners. It begins with caring and respecting all those we work with. We believe a culture of diversity and inclusion is vital to serve our unique and diverse customers. We seek for continues improvement and innovation and believe being agile and nimble is our advantage. We bring a strong sense of partnership to every relationship – internally and externally. The EmblemHealth family of companies offers competitive health, welfare, and retirement benefits as well as incentive pay plans and more.

Medicare Product Strategy Manager

📁
Manager & Professional
💼
EmblemHealth
Sign Up for Job Alerts

Accountable for obtaining, analyzing, synthesizing and publishing real time competitive intelligence and market information.  Identify and evaluate opportunities to improve and expand the Medicare product portfolio.  Develop recommendations on the current portfolio and expansion initiatives.  Manage and facilitate regulatory filings and bid submission activities for all Medicare product lines.  Cross team collaborator for the Medicare Product department; engages with the Product Administration and Regulatory teams on key activities and initiatives.

Responsibilities:

  • Perform detailed market research and competitor intelligence to determine competitive and market dynamics.
  • Lead product analysis to gain a comprehensive understanding of internal and external environmental influences and competitive pressures. Incorporate results into product planning development.
  • Develop a deep understanding of the Medicare industry, keep abreast of upcoming demonstrations, program changes, and proposed legislation.
  • Identify, analyze and interpret emerging trends impacting market position across multiple lines of business.
  • Manage the CMS bid process, works with Actuary, Sales, and other teams to develop product inputs, pricing and other key assumptions. Coordinate all supporting related activities.
  • Lead efforts for all regulatory filings related to Medicare, including but not limited to Medicare Advantage, Prescription Drug Plans, and Medicare Supplement.
  • Support the development of product portfolios, benefits, and programs that drive membership growth, improve member satisfaction and enhance revenue & profitability.
  • Establish and maintain a framework, schedule and artifacts for the product planning lifecycle
  • Develop a process to track and report results of product changes compared to plan.
  • Responsible for preparing presentations for business units and executive leadership. Must be comfortable presenting to all levels of the organization.
  • Serve as the subject matter expert to articulate and document benefit intentions including review and approval of external and internal benefit documentation.
  • Partner with internal business area to support Medicare Advantage employer group quoting process.
  • Coordinate with internal and external partners to ensure reporting packages are available as needed.
  • Develop and deliver product training as needed.

Qualifications:

  • Bachelor’s Degree required; MBA or equivalent preferred
  • 5 – 8 years of related work experience required
  • 3 – 5 years’ experience related to Medicare Advantage required
  • Knowledge of policies, procedures, contractual requirements and operations of Medicare programs preferred.
  • Effective communication skills: verbal, written, presentation, interpersonal required
  • Ability to deal with ambiguity and to interact with all levels of management required
  • Strong analytical skills with the ability to collect, organize, interpret, analyze, and disseminate significant amounts of information with attention to detail and accuracy required
  • Excellent organizational, prioritizing, multitasking, and time management skills required
  • Self-starter and independent thinker with strong initiative required
  • Advanced proficiency in Excel (and/or Tableau) and PowerPoint required

EEOC Statement

We are committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law.

Sponsorship Statement

Depending on factors such as business unit requirements, the nature of the position, cost and applicable laws and regulations, EmblemHealth may provide work visa sponsorship for certain positions.

Previous Job Searches

Similar Listings

EmblemHealth

Farmington, Connecticut

📁 Manager & Professional

ConnectiCare

Farmington, Connecticut

📁 Manager & Professional

ConnectiCare

Farmington, Connecticut

📁 Manager & Professional