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Product Manager- Payor/Medicare/Medicaid/Commercial

Location:

  • IL, DEERFIELD
  • Alabama, Alabama
  • Texas, Texas
  • Virginia, Virginia
  • Vermont, Vermont
  • Ohio, Ohio
  • Oregon, Oregon
  • Kansas, Kansas

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Description

Please Note: This position is Remote.

Please Note: Candidates will be expected to complete a case study if selected for interview

Responsible for the design and implementation of new products (Medicare Special Needs Plans, Medicare Advantage, Medicaid, and Commercial lines of business) within existing market/product lines. 

How you will make an impact:

Primary duties may include, but are not limited to:

  • Evaluates existing products and competitor and industry data to improve existing products and make recommendations for new products.
  • Coordinates presentation, communication and implementation of all phases of product development.
  • Ensures products meet competitive, regulatory (CMS, NCQA), and compliance needs. 
  • Reviews, analyzes, and makes recommendations on actions for existing products. 
  • Investigates market opportunities and effect on market for existing and new products.
  • Identifies system needs to support short- and long-term product strategy. 
  • Implements best practices within products and across other CareMore & Carelon products in a standardized manner and across markets.
  • Determines customer needs and preferences through research and analysis of industry technology, current processes, and other methods. 
  • Responsible for supporting the Product Lifecycle Management process to monitor product performance (clinical, financial, and operational) across all markets, as well as a competitive analysis research for benefits, market and regional data and trends.
  • Supports the development of short- and long-term strategic product promotions in support of market, sales, and profitability objectives. 
  • Establishes product development policies.

Qualifications:

  • Requires a BA/BS degree in a related field and a minimum of 2 years of related experience(Or)
  • Any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experience:

  • MBA
  • Health or managed care experience 
  • Strong strategic managed care understanding for Medicare Advantage, Medicaid, Commercial and chronic complex populations.
  • Extensive knowledge of CMS, NCQA regulatory guidelines.
  • Aptitude for independent strategic thinking as well as the ability to identify, leverage, and execute best practices while demonstrating a continuously innovative mindset. 
  • Critical thinker / problem solver willing to take initiative with minimal direction. 
  • Comfortable working in an agile “start-up” environment and demonstrated ability to lead and influence within ambiguous settings.
  • Extensive experience in data analytics, financial analysis, budgeting, and a keen ability to convert complex information into concise strategic business insights using PowerPoint, Excel, and other data management tools and clinical applications.
  • Exceptional communication skills (verbal and written) and executive presence.

Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2022, has been ranked for five years running as one of the 2023 World’s Most Admired Companies by Fortune magazine, and is a growing Top 20 Fortune 500 Company. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

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