Manager Medicare Product Strategy & Implementation

Location: Honolulu, HI
Job description
Creates and implements multi-year product strategies to support membership and revenue goals. Responsibie for ensuring that Kaiser has competitive and compliant set of products, plans, and capabilities in the market by leveraging customer research, market trends, and competitive intelligence. Evaluates, recommends, develops and implements projects related to Medicare business line for the Region. Leads staff that manage and coordinate complex projects with benefit, policy and process changes to ensure competitive market position, efficient/effective implementation to support Regional and National goals. Serves as a subject matter expert to the region on Medicare products, practices and policies.
 
Essential Functions:
• Manage the complete product mangement lifecycle including market assessment, existing portfolio evaluation, business plan creation and implementation. Influence and assimilate key constituents (clinical, operations, sales, etc.) to drive alignment and results.
• Lead and organize regional work groups to define and reach consensus on design, implementation, training and marketing of Medicare products to ensure market acceptance and efficient/effective implementation.
• Evaluate and develop product enhancement options by leading customer advisory committees and clinical consultant workgroups to gain and test insights on innovations that can be incorporated into product and benefit offerings. Conduct product development functions to create new products and value added services based on consumer and market insights and trends.
• Maintain high level of knowledge of assigned products and benefits by conducting competitive intelligence and partnering with market research to identify and exploit trends, and basic knowledge of ancillary products. Define policies for existing benefits.
• Oversee the development and evaluation of Medicare benefit enhancement options. Consult with appropriate staff and departments to ensure benefits and policies meet all local, state, and federal legal/regulatory requirements. Analyze and minimize impact of barriers to Medicare benefit and policy change critical to implementation.
• Lead and manage cross-functional project teams to implement Medicare products and product enhancements via the CMS bid process, and to orchestrate solutions and compromises required for resolution of benefit implementation issues and product development needs.
• Develop and present benefit and policy proposals that incorporate key considerations. Train and educate internal and external constituents on new Medicare products, benefits, and policies by developing educational tools and training programs.
• Provide consultative and problem solving services to regional and national staff, and to internal and external customers regarding Medicare products, benefits, and policies.
• Research emerging technologies and makes recommendations about incorporating into benefit package. Accountable for ongoing reporting of benefit and policy issues to impacted internal and external customers.
• Oversee staff that maintain systems related to assigned Medicare products and benefits. Ensure internal and external customers have information required to sell and administer products and benefits as designed. Function as subject matter expert and develop business cases for benefit system developments or improvements.
• Hires, trains, supervises, counsels, disciplines, and terminates assigned staff as appropriate.
• Communicates goals, objectives, accountabilities, priorities, and authority parameters to assigned staff.
Qualifications:
Basic Qualifications:
Experience
• Minimum seven (7) years of Medicare experience with health care products, benefits, and policies.
• Minimum five (5) years of program management experience.
Education
• Bachelor's degree in business administration, public health, or related field; OR four (4) years of experience in a directly related field.
License, Certification, Registration
• N/A

 

Additional Requirements:
• Demonstrated ability to consult, advise and translate customer needs into solution alternatives.
• Demonstrated knowledge of and skill in conflict resolution, decision making, group presentations, group process facilitation, influence, interpersonal relations, oral communication, written communication, problem solving, project management, quality management, results orientation, systems thinking, teamwork.
• Demonstrated knowledge of and skill in word processing, multimedia presentations, spreadsheet, and database PC applications.
• Working knowledge of state and federal regulations related to Medicare.
 
 
Preferred Qualifications:
• Master's degree in business administration, public health, or related field.
• Working knowledge of KP systems and operational processes.
• Working knowledge and experience with regulatory issues and standards to include implementation and compliance.
April A. Estes
Senior Recruiter
720-439-2609 Direct
april@proenlist.com 
www.proenlist.com 

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