Product Manager - Medicaid & Medicare Programs
BC BS Rhode Island - Providence, RI

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At Blue Cross & Blue Shield of Rhode Island (BCBSRI), diversity and inclusion are central to our core values and strengthen our ability to meet the challenges of today's healthcare industry. BCBSRI is an equal opportunity, affirmative action employer. We provide equal opportunities without regard to race, color, religion, gender, age, national origin, disability, veteran status, sexual orientation, gender identity or expression.
Responsible for the performance of a Government Program product. Manages assigned products, recommends courses of action related to product offerings, negotiates with external partners or vendors to develop programs and oversees implementation of benefit changes resulting from product initiatives or legislative and regulatory requirements. Act as point of reference for all departments on product benefits, rules, and policies. Supports and assists the Senior Manager in their responsibilities.  Â
REPRESENTATIVE JOB DUTIES (listed in order of importance, maximum of 10):
Researches, develops, and implements new products, benefit changes or product initiatives by reviewing product performance, market research, government laws and regulations, and market environment. Runs inter-departmental work groups to identify opportunities for product enhancement and implement new initiatives. Develop and manage project work plans to achieve necessary objectives and meet desired time frames. Â
Develop and implement work plan to attain goals for product performance and recommend revision to goals as necessary based on knowledge of strategic objectives and priorities. Create analysis that reflects product performance compared to stated goals. Identify issues and present recommended solutions to management. Respond to requests from sales representatives and Senior Management for customization of existing or new product offerings. The expected result is to maintain competitive products in response to market demand and in compliance with Corporate strategies. When appropriate, strive for product simplification and make product differentiation in the external environment an important goal. Investigates areas of unexpected trends or outcomes. Participate in annual financial forecasting process with ASA, including providing input to ASA on projected trends and revenue. Monitor provider reimbursement rates and determine financial impact on product. Become expert of government reimbursement mechanisms for product. Provide necessary information to ASA to estimate the value of initiatives targeted to increase product efficiency and improve financial outcomes. Participate in the creation and revision of member communication material for the Government Programs business unit. Projects include a variety of communication media including ads, brochures, direct mail, new member kits, sales kits, internal and external newsletters, overhead and on-screen presentations, benefit summaries and provider directories, among others. This is a critical deliverable for the business unit Draft or review the content of provider, community, and member notifications and oversee mailings related to new products, initiatives and/or benefit changes. Serve as key person to respond to questions and answers regarding marketing strategy and material. Analyze market research, product management and product development issues pertaining to assigned product(s). Review and analyze health care issues, economic trends to identify impact to Corporation and help formulate product and marketing strategies. Remain current on the appropriate market research, legal information, competitive intelligence, national trends and regional trends in order to facilitate the most informed marketing recommendation and product strategies. Prepare and deliver written and oral briefs to department management team as necessary. Monitor and track federal and state legislation that could affect Government Programs. Provide impact analysis and recommendations on product response to management. Review existing and proposed regulations for business impact Serve as a liaison between and among government programs and the Corporation in administration and configuration of product offering. Chair inter-departmental teams in the implementation of product enhancements or benefit changes to assigned products. Represent Government Programs and interests of assigned product(s) on ad hoc work groups and committees chaired by other departments. Identify and present issues to Director along with recommended solutions. Perform other duties as assigned KNOWLEDGE, SKILLS & ABILITIES REQUIRED:
Health insurance operations and health care issues, including managed care

Government health care programs (Medicare, Medicaid)Â

CMS and DHS regulations

Health care marketing strategies

Excellent written and verbal communication skills required

Proficiency with Microsoft office products

Strong analytical skills

Strong organizational skills, with a track record of managing multiple tasks effectively

Problem solving skills

Ability to take initiative in finding solutions to difficult and/or sensitive problems

Excellent presentation and negotiation skills

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BC BS Rhode Island - 2 years ago - save job - block
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