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Medicare Product Manager / Job Req 772068172

ALAMEDA ALLIANCE FOR HEALTH
Alameda, CA Full Time
POSTED ON 2/23/2025
AVAILABLE BEFORE 5/21/2025

PRINCIPLE RESPONSIBILITIES : Under the general direction of the Executive Director, Medicare Programs, the Medicare Product Manager is responsible for working within the product strategy, stars, sales, & marketing areas to identify and implement projects, programs, and initiatives that support the achievement of health plan goals as it relates to the Alliances Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) product. The incumbent works within management, business owners, and other key stakeholders to develop and manage the product go to market planning, prioritization, timelines, metrics / scorecards, budgets, return of investment (ROI) analysis, and working agreements for product initiatives. In addition, the position will collaborate with the Sr. Director, Medicare Sales and Marketing and the Manager, Medicare Sales and Retention to identify and develop other opportunities to increase brand awareness, lead generation, and member retention. The Manager is expected to remain current with market / industry trends and the competitive product landscape to ensure the team implements Medicare product tactics in a budget conscience, quality, and timely manner. The position will collaborate with Healthcare Analytics to regularly forecast, build reporting mechanisms, and provide updates to the Medicare Operations leadership if established targets and timelines are at risk. The Manager will have deep experience with Medicare and Medicare Advantage program management to ensure launches and expansions are successful. Working closely with senior and departmental leadership, the Manager will ensure effective performance and compliance with State and Federal regulatory requirements for all Medicare Advantage D-SNP benefit management, bid filling, and product launch. Principle responsibilities include : Assisting in providing strategic management oversight in developing, implementing, and monitoring the Alliances Medicare Program, including strategy development, product design, market positioning, and ensuring effective ongoing operational management. Leading cross-functional meetings within a matrix environment to meet overall stakeholder expectations and organization objectives. Supporting Medicare Advantage bid development to determine product and benefit changes in response to CMS requirements and market positioning.Acting as the business owner to supplemental benefit vendors and acts as a liaison from vendor point of contacts (POCs) to health plan leadership and stakeholders. Subject Matter Expert (SME) in Medicare and Medi-Cal benefits, understanding cross-over of benefits, managing the Product View Tool (PVT), and providing input for IT configuration for successful benefit output. Creating, implementing, and conducting internal and external training on Medicare Advantage D-SNP benefits and leads provider educational benefit roadshows. Assisting in conducting targeted outreach to community-based organizations, provider groups, member prospects, and current members to stimulate interest that leads to enrollments in the Medicare Advantage D-SNP product. Collaborating with the Alliance communications team in the creation of a Medicare Advantage D-SNP website and understanding the CMS Medicare and State regulations on what is required on the website, while adhering to enhancing member engagement and experience. Orchestrating, planning, and executing end to end product cycle operational readiness for annual product launch.Managing multiple benefits through full product development life cycle including requirements gathering, creation of documents and schedules, obtaining and manager resources, managing budget, and facilitating execution, deployment and closure. Collaborating with Alliance leaders to identify and close initial operational and analytical gaps to ensure a successful D-SNP go-to-market launch and perform ongoing assessments to ensure successful operational program management.Managing the Medicare Advantage D-SNP bid design process with key stakeholders, consultants, vendors, and Alliance leadership to meet deliverables and CMS deadlines. Leading and keying the Medicare Advantage D-SNP bid in HPMS and oversite of quality assurance in HPMS modules to ensure accuracy and completeness. Working cross-collaboratively with diverse staff in teams, working groups, members, doctors, elected officials, community partners, and vendors while maintaining and upholding a professional demeanor and to represent the Alliance at interviews, special events, official functions, meetings, and when conducting research.Maintaining overall creative playbooks, workplans, dashboards, and other project management capabilities to determine effectiveness of plans and activities to ensure on-time production of product strategic initiatives. Identifying opportunities and assisting in training to increase the benefit and product knowledge of the Alliance organization, while collaborating with Medicare Operations leadership, Trainer, and Curriculum Designer. Creating policies, standard operating procedures (SOPs), productivity standards, roadmaps, reporting, and Key Performance Indicators (KPIs) in a timely manner. Negotiate with stakeholders to identify and secure resources, resolve issues, and mitigate risks. ESSENTIAL FUNCTIONS OF THE JOB : Assume responsibility and exercise good judgement in making decisions within the scope of authority of the position.Be proficient in understanding CMS Marketing and Communications Guidelines (MCMGs), Code of Regulations (CFRs), and model documents.Demonstrate strong organizational, time management, and project management skills and multi-tasking abilities.Manage small to extra-large level initiatives which may require coordination with external partners.Provide support to Project Management Office (PMO) and various enterprise-wide activities based on availability.Organize and facilitate Medicare program project-related meetings, as necessary.Work effectively independently as well as part of a team and support team decisions.Adapt to changes in requirements / priorities for daily and specialized tasks.Produce accurate and precise work, detect discrepancies, and resolve discrepancies all while meeting deadlines.Demonstrate strong analytical skills and problem-solving skills as well as formulate and communicate recommendations for improvements as needed. PHYSICAL REQUIREMENTS : Constant and close visual work at a desk or a computer.Constant sitting and working at a desk.Constant data entry using a keyboard and / or mouse.Frequent use of a telephone headset.Constant verbal and written communication with staff and other business associates by telephone, correspondence, or in person.Frequent lifting of folders and other objects weighing between 0 and 30 lbs. Frequent walking and standing. Occasional driving of automobiles. Number of Employees Directly Supervised : 0 Number of Employees Indirectly Supervised : 0 MINIMUM QUALIFICATIONS : EDUCATION OR TRAINING EQUIVALENT TO : A Bachelors degree in Business, Health Administration, health-related field, or equivalent work experience. MINIMUM YEARS OF ADDITIONAL RELATED EXPERIENCE : Five (5) years of experience in project implementation, product or program management experience. Five (5) years of experience in the managed care industry with Medicare Advantage related experience. Medicare supplemental benefits (Dental, Vision, Hearing, etc.) experience strongly preferred. CMS filling experience strongly preferred. SPECIAL QUALIFICATIONS (SKILLS, ABILITIES, LICENSE) : Excellent written, verbal, and interpersonal communication skills, and ability to successfully interact with people at all levels. Ability to facilitate meetings, manage complex initiatives, and make presentations before groups of management and staff. Exhibits good tasks, planning, and implementation skills to ensure work is completed on time and to expected quality levels.Strong collaboration skills with demonstrated ability to create and foster a collaborative work environment, while maintaining effective, high-performance teams.Strong organizational skills with the ability to effectively prioritize multiple tasks and meet deadlines.Ability to lead effectively in a matrixed environment.Ability to communicate effectively orally and in writing.Basic knowledge of the business, economic, demographic and political trends and developments affecting healthcare in general, and sales and marketing in particular.Experience with project management Intermediate skills in Microsoft Office Suite including Outlook, Visio, Word, Excel & PowerPoint.Ability to manage confidential information with appropriate discretion.5% to 10% occasional travel required. Valid CA drivers license, proof of insurance and good driving record. SALARY RANGE : $167,440.00 - $251,160.00 Annually The Alliance is an equal opportunity employer and makes employment decisions on the basis of qualifications and merit. We strive to have the best qualified person in every job. Our policy prohibits unlawful discrimination based on race, color, creed, gender, religion, veteran status, marital status, registered domestic partner status, age, national origin or ancestry, physical or mental disability, medical condition, genetic characteristic, sexual orientation, gender identity or expression, or any other consideration made unlawful by federal, state, or local laws. M / F / Vets / Disabled.

Salary : $167,440 - $251,160

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