Product Manager, Medicare
Medicare Product – Medicare Product
ABOUT THIS ROLE
Bright Health’s Medicare Product Team oversees the Medicare Advantage product portfolio and directly supports Bright Health’s Medicare Business and its key initiatives related to Medicare Advantage, including overall growth, new market entry, retention, Stars performance, and general plan performance. The Medicare Product Team operates cross-functionally to develop a competitive and differentiated portfolio and deliver on core business objectives.
As the Medicare Product Manager, you will lead the Medicare Product Team and be responsible for the design and development of Bright Health’s Medicare Advantage product portfolio. You will analyze market and regulatory dynamics, identify strategic opportunities for our product portfolio, and execute against these opportunities. You will work across the organization and interface with our Care Partners to support delivery of Bright Health’s organizational and strategic objectives. Your work will directly contribute to the rapid growth and expansion of Bright Health and its Medicare Business.
- Responsible for Bright Health’s Medicare Advantage product portfolio, the end-to-end product development and innovation cycle, and product strategy
- Manage bid development process and work with actuary and other teams to develop product inputs, pricing, and other key assumptions; Coordinate with Supplemental Benefits Team to direct relevant research and vendor engagement to support product portfolio requirements
- Develop market intelligence and research to determine competitive/market dynamics and identify key strategic initiatives; Lead the execution of identified initiatives across cross-functional work groups
- Identify key cohorts and opportunities for achieving short- and long-term membership growth goals across products and service areas; Work with regional leaders to localize products and serve the needs of geographic service areas and specific providers
- Support and contribute to key strategic initiatives for the Medicare business, including growth, retention, member experience, Stars-related initiatives, and plan performance
- Serve as the subject matter expert on the Medicare product portfolio; Develop and manage product portfolio overview documents with detailed plan design documentation
- Provide guidance and research regarding claims configuration, benefit interpretation, and customer service needs to support retention and growth strategies
- Develop and deliver product training to internal and external stakeholders, including customer service, sales, and market leads
- Contribute product-related content and guidance for marketing materials and key regulatory materials, including the ANOC/EOC and Summary of Benefits
- Develop and maintain an in-depth knowledge of CMS regulations, guidelines and timelines related to benefits; Synthesize updates to key CMS regulations/programs, including the Medicare Managed Care Manual, HPMS memos, and CMS special demonstration programs (e.g., VBID Model), provide strategic insight for impact to Bright Health product portfolio, and develop recommendations for capturing related opportunities
- Meet with Care Partners and network providers to support new market development, communicate Medicare portfolio strategy, and collaborate on product design
- Lead process documentation, project management, progress tracking, and process improvement efforts related to the responsibilities outlined above
- Other duties and responsibilities as assigned
- This position has supervisory responsibilities for the Medicare Product Team, including direct management of the Medicare Product Specialist. Position also has indirect management responsibilities for Supplemental Benefits Team, Regulatory Manager, and Strategy Associate.
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
- Bachelor’s degree is required; MBA is preferred
- Seven (7) or more years of experience within the healthcare industry required
- Three (3) or more years of Medicare Advantage product management/development experience, including bid development and actuarial analysis required
- Two (2) or more years of experience managing employees required
- Experience preparing regulatory documents and filings for CMS submissions is required.
- Experience managing processes end-to-end and continuously improving these processes to promote efficiency and compliance is required.
- Proven Medicare Advantage product strategy and development experience
- Strong attention to detail and analytical skills
- Excellent presentation and communication skills, both written and verbal
- Ability to scope and project manage complex, data-heavy processes across an organization
- Ability to collaborate cross-functionally across departments and various level roles in the organization
- Understanding of Medicare regulatory requirements and the Medicare Stars Program
- Willingness to learn and operate in ambiguity
The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer. Some travel may be required.
At Bright Health, we brought together the brightest minds from the health care industry and consumer technology and together we created Bright Health: a new, brighter approach to healthcare, built for individuals. Our plans are easy to manage, personalized and more affordable, giving people the quality care they deserve. Through our exclusive care partnerships with leading health systems in local communities we are reshaping how people and physicians achieve better health together.
Bright Health is tripling its footprint in 2019 to offer a variety of health insurance plans to more individuals. Bright Health operates health insurance offerings across Individual and Family Plan segments and the Medicare Advantage space in Alabama, Arizona, Colorado, Ohio, New York and Tennessee.
We’re Making Healthcare Right. Together.
We've won some fun awards like: Great Places to Work, Modern Healthcare, Forbes, etc. But more than anything, we're a group of people who are really dedicated to our mission in healthcare. Come join our growing team!
As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.