Principal, Adjudication Product Management

Exemption Status :

United States of America (Exempt)

114,622 - $160,472 - $206,321

Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate."

This position is not eligible for Sponsorship.

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description

Summary :

The Principal, Adjudication Product Management leads the overall strategy, goals, and objectives for MedImpact's Laker Adjudication Platform. This position will be the product lead and will drive initiatives with the Laker product management team and IT. Creating, maintaining, and executing on the product(s) strategic vision and roadmap by serving as a trusted partner to business and technical owners, including but not limited to, Operations, Clinical, Account / Client Management, IT, and Customer Service.

The position's focus will be to lead the creation and support of key adjudication products from inception to execution and document and prioritize critical product features that impact bottom line performance. Working across the organization the Principal, Adjudication Product Management focuses on delivering products that provide meaningful value to users and customers of our PBM and Software as a Service (SaaS) offerings. Works with a range of internal partners and external partners, gathering their perspectives throughout product roadmap creation and evolution.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• This position is responsible for leading the strategy and execution of product enhancements and end-of-life planning for existing claims and adjudication products and services from concept through deployment. Ensures products and services are successful, meet corporate operational excellence criteria and support revenue goals.
• Leads the research, development, and implementation of adjudication products and services. Identifies, analyzes, monitors, and suggests actions for products and services that materially contribute to overall mission and strategy of the company.
• Evaluates new product development opportunities and existing product enhancements based on regulatory and / or client need. Leads product feature prioritization with business and technical stakeholders to ensure product features are prioritized appropriately.
• Develop business cases from internal and external clients for new product builds or enhancements of existing products. Collaborate with IT stakeholders to obtain high level and detailed budget estimates to support business cases and system development.
• Leads the conceptualization, design, product development and implementation of approved new and expanded products & services utilizing industry standard methodologies for product lifecycle management. Working with business owners, IT stakeholders, and Product Readiness to ensure proper product documentation and testing of systems before solutions are moved to the production environment, including that required for product release, training, and postproduction support.
• Responsible for the execution of simultaneous products under development, from product concept and approval through deployment. This will include ownership or support of product strategy definition and roadmap; development of marketing and product requirements documents with prioritized features and corresponding justification in partnership with business owners and technical stakeholders; prototype development; and development of strong voice of the customer and competitive intelligence. This position will interface with other areas within the company, including but not limited to IT, Sales & Marketing, Operations, Finance / Analytics and Project Management.
• Provides product management oversight for assigned products and services, including annual strategic product planning; revenue and expense budgeting and forecasting; pricing; support of product and sales material development; product training, assessment, and support; RFP support; and product demonstrations.
• Serves as the primary subject matter expert for cross functional business units for claims and adjudication product development and management.
• Conducts market and regulatory analysis by retrieving information from a variety of sources, including but not limited to proprietary databases, Internet, focus groups and other data sources. Utilizes information retrieved to conduct research and analysis and presents results to leadership and product teams.
• Completes all documentation throughout the product or project lifecycle, including creating business cases, business plans, business requirements, and product roadmaps.

Supervisory Responsibilities

May manage assigned staff in the segment area. May be responsible for the overall direction, coordination, and evaluation of this unit. May carry out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities may include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. Supports and enforces all company policies and procedures in a fair and consistent manner, taking corrective action whenever necessary.

Client Responsibilities

This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening / verbal / written). One must be able to; Respond promptly to client needs; Facilitates client feedback to improve service; Manages client expectations as it relates to products and services; Respond to requests for service and assistance from clients; Meet commitments to clients; Manage difficult or emotional client situations.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and / or Experience

Bachelor's degree from an accredited college or university; 10 or more years' experience in new product development, adjudication product management and new product marketing and / or training; or equivalent combination of education and experience. Minimum of 5 years of experience in PBM or PBM-related functions, including PBM claims adjudication, benefit setup and pharmacy operations in the Medicare space.

Computer Skills

To perform this job successfully, an individual should have knowledge of Microsoft Office Suite, Microsoft Project and a working knowledge of systems platforms and new technologies.

Certificates, Licenses, Registrations

Product Management Certification (e.g. AIPMM, PDMA, Pragmatic Institute) preferred.

Project Management Professional and Certified Scrum Master certification preferred.

NCT-NCPDP Telecommunication Standard certification required

Other Skills and Abilities

Reasoning Ability

Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

Mathematical Skills

Candidates must have an understanding of pharmaceutical calculations including fractions, decimals, ratios, proportions, percentages, and medication dosing. In addition, candidates must have the ability to calculate and / or interpret market shares and graphs.

Language Skills

Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, policies and procedures, and business correspondence. Ability to effectively present information and respond to questions from groups of managers, clients, and customers.

Competencies To perform the job successfully, an individual should demonstrate the following competencies :

Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data.

Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Uses reason even when dealing with emotional topics.

Oral Communication - Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings.

Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.

Business Acumen - Understands business implications of decisions; Displays orientation to profitability; Demonstrates knowledge of market and competition; Aligns work with strategic goals.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee is regularly required to sit and talk or listen. The employee is occasionally required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and / or move up to 35 pounds.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually moderate.

Work Location

This position works on site at the San Diego Headquarters or other company location (or from a remote location with management approval based on business requirements). Must provide adequate support to internal clients; be available for regular interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as be available to facilitate effective decisions through collaboration with stakeholders.

Working Hours

This is an exempt level position requiring the incumbent to work the hours required to fully accomplish job responsibilities and reasonable meet deadlines for work deliverables. The individual must have the flexibility to work beyond traditional hours and be able to work nights, weekends or on holidays as required. Work hours may be changed from time to time to meet the needs of the business. Typical core business hours are Monday through Friday from 8 : 00am to 5 : 00pm.

Travel

This position requires domestic travel of up to 10% of the time.

The Perks :

To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com / careers

MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego,

California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.

Equal Opportunity Employer, Male / Female / Disabilities / Veterans

OSHA / ADA :

To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and / or ability required.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Disclaimer : The above

statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.

Salary : $114,622 - $160,472