PacificSource Health Plans

Medicare Product Strategist

US-OR-Portland
Job ID
2017-437
Type
Regular Full-Time
Hiring Pay Range
$50,000-$60,000
# of Openings
1
Status
Exempt

Overview

Position Overview: This position is responsible for the coordination and execution of product development, implementation, and maintenance of Medicare plans, including Medicare individual plans, employer group plans, and special needs populations. Key areas of focus include 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 executing annual bid submission, maintaining product/plan updates and documentation, and ensuring bid submissions are accurate, timely, and in compliance with State and Federal regulations.

Responsibilities

Essential Responsibilities:

  1. Coordinate and execute product development and maintenance of Medicare insurance programs, including market research, competitive analysis, product and compliance requirements, maintaining plan design and product documentation, and the data and research to support decisions. Develop and maintain an in-depth knowledge of CMS regulations, guidelines and timelines related to benefits.
  2. Execute the annual bid process ensuring timeliness and accuracy, and maintain plan design documentation. Facilitate the development and implementation of new benefits, benefit changes, service area expansion, and plan consolidation.
  3. Gather information about new product concepts specific to product line and local market areas, and work with the Medicare Product Director to design, introduce, and incorporate those concepts into overall portfolio. Gather and analyze market data, competitor products and pricing, survey information and market trends, and provide regular and ad hoc analysis and reports.
  4. Facilitate and execute 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.
  5. 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.
  6. Prepare and deliver presentations to internal teams, members, brokers and external audiences to solicit support in the development, implementation or continued monitoring of products with regard to administration, enrollment, claims, benefit utilization, and market acceptance.
  7. Review, update, and maintain product/plan information for both internal and external channels to ensure content is accurate. Maintains thorough knowledge of Federal and State regulations, health insurance markets, and industry trends.
  8. Experience compiling and interpreting large data sets from CMS.gov, or other federal reporting agency.
  9. Comfortable with ambiguity, and embracing change in dynamic environments.
  10. Extensive knowledge of Medicare. Including the ability to respond and network with external partners.
  11. Follows standards, and written policies and procedures.

Supporting Responsibilities:

  1. Meet department and company performance and attendance expectations.
  2. Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
  3. Perform other duties as assigned.

Qualifications

Work Experience: Minimum of three years industry experience, preferably in healthcare insurance environment.  

 

Education, Certificates, Licenses: Bachelor degree in Business, Marketing or other related field is preferred. 

 

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). Must be self-motivated and able to work both independently and as a team member. 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.

 

Competencies

Our Values

  • Adaptability
  • Building Customer Loyalty
  • Building Strategic Work Relationships
  • Building Trust
  • Continuous Improvement
  • Contributing to Team Success
  • Planning and Organizing
  • Work Standards
  • We are committed to doing the right thing.
  • We are one team working toward a common goal.
  • We are each responsible for our customers’ experience.
  • We practice open communication at all levels of the company to foster individual, team and company growth.
  • We actively participate in efforts to improve our communities-internal and external.
  • We encourage creativity, innovation, continuous improvement, and the pursuit of excellence.

 

Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 15% 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.

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