Become a part of our caring community and help us put health first
 

Humana Medicaid is seeking exceptional candidates to join our Medicaid Product Strategy Organization in order to support the strategic direction and growth of the Medicaid and Duals lines of business. This is a unique opportunity for a motivated individual to influence the mission of a leading healthcare company committed to improving the health of the communities it serves.
We are a diverse set of highly skilled people with deep Medicaid subject matter expertise who work in an agile, collaborative environment. To achieve our goals we empower associates to pioneer simplicity, rethink routine and seek talent with the following attributes
• Creative – Adept at research to determine the opportunity and a structured yet flexible approach to problem solving.
• Adaptive - Rapidly learn new knowledge, skills and behaviors in response to changing circumstances
• Self-sufficient - Ability to navigate complex situations and independently produce high quality deliverables
• Consultative – Build/sustain relationships and inform the work of others through actionable, objective insights
• Strategic – Forward thinking capable of providing frameworks to maximize available resources to achieve growth

The Medicaid Senior Insurance Product Manager plays a critical role in developing and managing Medicaid and Dual Eligible insurance products and services that meet the needs of Humana’s customers while aligning with its business objectives.

The Medicaid Senior Insurance Product Manager plays a critical role in developing and managing Medicaid and Dual Eligible insurance products and services that meet the needs of Humana’s customers while aligning with its business objectives. Responsibilities include:  

 

• Translate requirements and guidance from federal and state government to define health plan covered service packages and eligible cohorts.
• Communicate covered services and pertinent insurance product information to operational partners, ensuring information is organized, complete and accurate.
• Understand Humana Medicaid and Dually Eligible Customers by researching their needs and pain points and designing consumer centric, easy to use benefits while remaining responsive to both State and Federal requirements and goals. 
• Analyze industry trends and the marketplace to ensure Humana benefits remain attractive.
• Evaluate benefit performance to develop data driven insights to inform benefit design.  
• Collaborate with market leaders and various operational teams (clinical, population health, network, finance and actuary) to design value added benefit and In lieu of Service packages that delight key customers and support sustainable health plan operations.
• Lead product and benefit filing efforts with the regulatory agencies in a timely and complaint manner ensuring that Humana benefits remain administered and delivered.
• Provide subject matter expertise to investigate and resolve escalated benefit inquiries and complex benefit-related issues.
• Supply benefit related information to support the development of accurate internal and external facing communications.
• Provide written and verbal communication to executive level leadership. Clearly deliver pertinent data to inform effective decision making to advance product strategy. Serve as a mentor and leader to junior level positions on the team and work collaboratively to ensure Humana Medicaid product is operating as intended.

Use your skills to make an impact
 

Required Qualifications

• Bachelor’s Degree in an appropriate area of knowledge (e.g. health care, business administration etc.)
• Minimum of 3+ years of related work experience with Medicaid and Duals products and services 

Working knowledge of health plan product coverage and benefit concepts

• Strong attention to detail with a proven ability to accurately identify and interpret regulatory and contractual guidance
• Adept at performing competitor analysis to synthesize the marketplace and produce actionable insights.
• Experience working collaboratively across multiple functional areas (e.g., operations, finance, clinical, actuary, configuration) and fostering teamwork
• Excellent communication skills (written, oral and presentation skills)
• A growth mindset who thrives on taking on new challenges and embraces working in a fast-paced changing environment
• Ability to use data and analytical thinking to make fact-based decisions and/or recommendations
• Advanced Proficiency in Microsoft Office applications, including Word, Excel, and, PowerPoint

Preferred Qualifications

• MPH or MBA or similar higher-level education
• Clinical operations and medical coding expe