This position supports the development, implementation, and maintenance of Medicare plans, including Medicare individual plans, employer group plans, and special needs populations. Key areas of focus include assisting in the quantitative and qualitative product analysis on existing and emerging insurance markets, products, and competitors, as well as ongoing monitoring of tactics and results. This position is also responsible for providing support in annual bid submission, maintaining product/plan updates, participation in all phases of the Medicare product lifecycle process (from concept through implementation), and ensuring bid submissions are accurate, timely, and in compliance with State and Federal regulations.
Assist with the development, implementation, and maintenance of Medicare insurance programs, including market research, competitive analysis, product and compliance requirements, and the data and research to support decisions. Develop and maintain an in-depth knowledge of CMS regulations, guidelines and timelines related to benefits.
Provide support for the annual bid process ensuring timeliness and accuracy, and maintain plan design documentation. Assist with the management of projects including the implementation of new benefits, benefit changes, service area expansion, and plan consolidation.
Gather information about new product concepts specific to product line and local market areas, and work with the Product Director to design, introduce, and incorporate those concepts into overall portfolio.
Provide support for service area expansion projects as a subject matter expert to ensure successful application submissions. Evaluate opportunities, and assist in the evaluation of existing products for consolidation and closure.
Serve as a point-of-contact for internal customers regarding our Government products and services. Interface with customers and coworkers to gather feedback to enhance existing products and actively participate as a Medicare product representative in assigned committees, projects, and meetings. Work with Communications and Sales Departments to update forms, sales, and marketing materials for new products/plans or product changes.
Review, update, and maintain product/plan information for both internal and external channels (such as medicare.gov, Medicare & You, and eHealth) to ensure content is accurate. Document and track information related to Government products, plans, and benefit changes.
Gather and analyze market data, competitor activity, competitor products and pricing, survey information and market trends, and provide regular and ad hoc analysis and reports.
Experience compiling and interpreting large data sets from CMS.gov, or other federal reporting agencies.
Work Experience: Minimum of three years industry experience, preferably in healthcare insurance environment.
Education, Certificates, Licenses: High school diploma or GED required.
Knowledge: Ability to work in cross-functional, collaborative relationships with internal partners. Excellent analytical and organizational skills, including time management, follow-through, and coordination with other staff. Provide timely and accurate responses to client needs and requests. Intermediate Computer Skills in a Windows Operating System. Proficient in Microsoft Office Applications. Experience in problem resolution and associated research. Use software/tracking technology to keep all key partners on track and informed of the project status. Proficiency in Microsoft Office software (Access, Excel, Outlook, PowerPoint, and Word). Advanced written and verbal communication skills. Strong math skills, including percentages, ratios, statistics, graphing and spreadsheets. Requires the ability to define and prioritize work without direct supervision. Must be self-motivated and able to work both independently and as a team member.
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.
Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.