The Manager of Operations Product Management is responsible for working cross functionally to make sure that all products are administered according to approved benefit design and regulatory requirements. The incumbent will be accountable for service and operational requirements associated with the products.
Essential Duties and Responsibilities:
Other Duties and Responsibilities:
- Ensure accurate and timely benefit setup for all lines of business by working with IS, Enterprise Operations, Ancillary teams, and other departments. Incumbent will work with technical team to develop business requirements and technical specifications.
- Drive member material execution by establishing process and maintaining oversight for distribution of member ID cards, welcome kits, letters, and other required product communications.
- Lead issue root cause identification and resolution for operational issues as they arise. Presents issues to reliability committee and works with designated team to ensure timely resolution.
- Lead ad hoc and special projects as determined by the department.
- Assists in the development of department policies and procedures in support of overall departmental operations and management of products.
- Assists with management of vendors that deliver key benefits and services to our members.
- Serve as representative for product team on internal committees, as assigned.
Required: Bachelor’s degree.
Work Related Skills and Experience:
Technical Skills :
Intermediate Microsoft Word, Excel and Adobe Acrobat (for editing purposes) skills are required. Intermediate experience using a corporate e-mail system (i.e. Microsoft Outlook, Lotus Notes, etc.) is also required.
1. A minimum of three years of experience required in the managed health care environment, including at least one of the following:
2. Prior Medicare Advantage, Medicaid, and/or Commercial experience.
- Product Management: Interpretation of benefits from State contracts and federal guidance
- IS or Operations: Business analysis in setting up benefits and/or developing technical specifications
- Regulatory Compliance: Experience in applying Medicaid and/or Medicare requirements to plan operations.
3. Ability to communicate effectively both verbally and in writing.
4. Strong analytical and research skills.
5. Ability to handle multiple projects simultaneously and adjust to changes quickly while meeting all deadlines.
6. Ability to multi-task and efficiently work in a demanding and fast paced environment.
7. Ability to exercise judgment and discretion of sensitive or confidential matters.
Supervisory or management experience preferred.
While performing the duties of this job, this employee will be occasionally reaching, bending, standing, traveling and occasionally lifting/carrying and pushing/pulling 1-10lbs. This employee will also be frequently sitting, overhead lifting and keying.
Work Environment :
This employee will constantly be in an indoor environment.
Healthfirst offers a comprehensive benefits package including, but not limited to:
Conditions of Employment: Employee must pass pre-employment screening which includes a background check and drug testing. Employee must present documentation to verify minimum of high school educational requirement.
- Basic Life and Accident Insurance
- Supplemental Life insurance
- Dependent Life Insurance
- Short-Term Disability
- Buy-Up Short Term Disability
- Long-Term Disability
- Flexible Reimbursement Accounts
- Healthfirst 401(k) Plan
- Employee Assistance Plan
- Commuter Savings Program
- Eligibility for Annual Bonuses
- Generous Paid Time Off program
- Paid Candidate Referral Program
Disclaimer: The statements herein are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.
All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, national origin, disability or veteran status .
Healthfirst - 15 months ago
Healthfirst is a not-for-profit managed care organization sponsored by some of the most prestigious and nationally recognized hospitals and...