The Product Manager is responsible for the ensuring the performance and success of NHPRI’s business products,
oversees performance standards associated with product. The Product Manager is accountable for all service and
operational requirements associated with the product or program. The position works closely with Neighborhood’s
Compliance Officer to meet all contracted/regulatory and reporting requirements. The position serves as the Subject
Matter Expert and primary lead for the fully integrated Medicare and Medicaid product.
* Minimum of a Bachelor’s Degree or sufficient work experience to equal the degree.
* Two to four years of Medicare Advantage operations experience
* Computer skills required ( Microsoft Office)
* Superior written and oral communications required
* Excellent quantitative analysis skills required
* Ability to build and maintain relationships internally and externally
* Strong leadership skills required
* Ability to lead and manage in a cross-functional environment
* Ability to work independently in a flexible environment
* Preferred detailed knowledge of Medicare Advantage regulations and experience CMS Health Management Plan System
* Contract management experience
Duties and Responsibilities - Responsibilities include, but are not limited to the following:
o Leads cross-functional teams
o Ensures accuracy of all required member and regulatory material
o Manages multiple projects in an efficient, timely manner
* Product Strategy
o Conducts competitive analysis, planning for new product offerings, leads the organization through benefit
design and pricing decisions.
o Identifies and coordinates with Senior Management on vendors needed for increased efficiency and quality.
o Develops and oversees the implementation of new programs and operational processes to ensure resource
optimization and compliance with established government standards, regulations, and customer objectives.
o Develops and maintains product goals, policies, short and long range strategic planning activities.
o Understands the political environment and its potential impact on the product.
* Product Management
o Ensures the benefit design and member materials conform with applicable regulatory requirements.
o Collaborates with business owners to ensure new benefit implementation.
o Coordinates CMS and State applications.
o Develops overall product/program budget based on utilization and financial data in support of product/program
o Assists in the development of and reviews department policies and procedures in support of overall
departmental operations and management of the product/program.
o Develops and maintains relationships, including state and federal partners. Receives, reviews all program
notices, and ensures implementation of contract requirements
o Provides guidance to business areas to ensure any/ all regulatory guidance and contract changes are accurately
implemented; responds to staff inquiries
o Works closely with Compliance Officer to coordinate interpretation and communication of regulatory and
o Acts as project manager for ( CMS/State) readiness and site visits.
o Coordinates reporting and oversees the collection of data and production of reports needed to meet the
requirements of the product or program and satisfy any regulatory, accreditation, or legal obligations.
o Reviews all reports, able to account for product/program performance and provide analysis of trends and issues
as such participates in activities associated with medical expense management.
o Facilitates ongoing improvement cycles to continuously improve performance of the program and position.
o Serves as representative for the product/program on internal and external committees, as assigned.
* Collaborates with the Director of Business Development and team colleagues to develop and define the ongoing
structure of product management within NHPRI.
* Other duties and projects as assigned by Director.
Neighborhood is an EOE M/F/D/V and an E-Verify Employer.
Neighborhood Health Plan of Rhode Island - 18 months ago
The overall health of the people of Rhode Island is overseen by the Rhode Island Department of Health, which is overseen by a...