Group Medicare Insurance Product Manager
HumanaAbout the role
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The Insurance Product Manager is responsible for a portfolio of product offerings within the Group Medicare (EGWP) segment and will have ownership of assigned plans from inception to CMS approval.This professional has accountability for the accurate and appropriate documentation of benefit decisions into systems of record, bid filing submissions and member communications. Decisions are based on an understanding of department, segment, and organizational strategy and operating objectives, including their linkages to related areas. You will report to the Manager of Group Product Design.
The Insurance Product Manager is responsible for a portfolio of product offerings within the Group Medicare (EGWP) segment and will have ownership of assigned plans from inception to CMS approval.
This professional has accountability for the accurate and appropriate documentation of benefit decisions into systems of record, bid filing submissions and member communications. Decisions are based on an understanding of department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Responsibilities include the following:
- Oversee the implementation of client benefit offerings, managing annual plan changes and documentation across approximately 40 milestones.
- Perform comprehensive audits tied to all CMS required Member Annual Communication (MAC) Materials, Humana, and client specific materials
- Deliver daily accurate portfolio status updates to functional leaders within shared tracking systems
- Adhere to established process flows to consistently achieve departmental performance metrics
- Participate in the Request for Procurement (RFP) process, creating plan designs for potential clients that match/exceed their current plan design, navigating competitor documents and resolving ambiguous benefit questions
- Working daily and extensively with Microsoft Excel, Forms, Outlook, Power Point, SharePoint, Teams, Adobe Compare and various databases to manage and execute on deliverables
- Develop and maintain business partner collaboration, which fosters a strong daily partnership and facilitates operational effectiveness
- Progressively assume increased thought‑leadership responsibility within the first 1–2 years by identifying product gaps and effectively translating complex benefit information into strategic benefit upgrades
- Support task-oriented project work while developing an understanding of key concepts and strategy, with the expectation of progressively leading projects as part of individual, team, and departmental growth
Success in this position requires the following:
- Meeting/Exceeding defined departmental metrics to include cycle time, quality and benefit accuracy
- Daily Demonstration of Experience communicating complex technical concepts to a variety of audiences in a matrixed organization. i.e. knowing what to communicate, when, to whom, etc.
- Demonstrate the ability to navigate and resolves complex situations, by making sound decisions and clearly explaining the logic behind those decisions
- Strong time-management Experience managing multiple simultaneous projects
- Demonstrates a desire to grow, progressing from building product knowledge to identifying opportunities for product enhancements
- And embrace change
- And collaboratively, knowing when to pivot accordingly
- Digital and technical proficiency Willingness to participate in professional development activities to stay current on industry knowledge
- Work assignments are cyclical, in accordance with CMS deadlines and at times throughout the year will require weekend and extended hours
Use your skills to make an impact
Required Qualifications:
- 2+ years of insurance operations experience
- 2+ years of experience working multiple projects with multiple deadlines
- Utilize Microsoft Excel, Outlook, PowerPoint, SharePoint and Teams, and various databases to manage and implement deliverables
- Closing process gaps, identification of potential innovation in processes and projects
- 2 + years of robust auditing experience with documents and reports within multiple applications (e.g., Microsoft Excel, PowerPoint and Teams)
- Prior experience working collaboratively across multiple teams or departments
- Will work overtime and weekends
Preferred Qualifications
- Bachelor's degree
- 2+ years data mining experience within Excel (can maintain complex spreadsheets)
- Experience with Microsoft Forms and Adobe Compare
- Knowledge of Medicare plan design
- Experience with supplemental insurance products
- Experience with CMS regulations
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