Director Medicare Product Development 1078257

Discovery Solutions Published: November 14, 2017
Job Type


Director, Medicare Product Development
This is a leading multi-line healthcare enterprise that provides services to government healthcare programs for under-insured and uninsured people.
DESCRIPTION: Manage the development, implementation and administration of Medicare Special Needs product. Oversee integration of internal operations needed to ensure compliance with state and federal requirements, interact with federal and state regulatory personnel and responsible for internal/external communications. Coordinate with Corporate on execution of Medicare SNP strategy.
: Research and implement new business opportunities in the Managed Medicare/Special Needs arena.
: Coordinate cross-functional meetings with various functional areas to meet overall stakeholder expectations and plan's objectives.
: Create policies and procedures in accordance with state and federal requirements and maintain compliance.
: Manage the operation and administrative functions for Medicare/Special Needs Plan.
: Oversee the development and maintenance of the provider network for Medicare/Special Needs Plan.
: Liaison between the corporate Medicare product team and Health Plan; also liaison between organization and State and Federal points of contact
: Examine and evaluate demographic, historical and geographic membership data.
: Travel to various locations as needed, minimum of 20%.
EXPERIENCE: 5+ years of Medicare and/or Special Needs health plan experience, preferably with Medicare Health Plan. Operating experience including medical management, marketing, provider network, operations and compliance. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.
:Past formal leadership abilities in a matrix environment
:Bid development/benefit filing experience
:New market implementation for Medicare Advantage experience
:Exposure to HPMS (Health Plan Management System)
EDUCATION: Bachelor's degree

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