Product Manager III - Madison, United States - Medica

Description

Medica's Product Manager III is responsible for the Medicare/QHP provider service area and network adequacy oversight.

Working closely with Product Management and Network Management Contracting teams, this Product Manager will be responsible for identifying, documenting, and pursuing opportunities for new products and expansion, including provider partnerships.

This role serves as a Subject Matter Expert regarding CMS/QHP business requirements and maintains open dialogue in support of shared success, including readiness of network(s) to meet new product development and maintenance needs.

Supports Medica's products for CMS/State network adequacy compliance, Medica's access and availability committee regarding Medicare/QHP provider network requirements and status.

Key Accountabilities:

Works closely with business segment leadership, product managers, network management, and sales to determine the network service area contracting requirements and feasibility, to support Medicare/QHP product initiatives for growth and maintenance.

Provides interpretation of related CMS/QHP guidance including oversight of the CMS Product application process, new products and service area expansions to ensure CMS compliance and approval.

Oversight of CMS/QHP annual network adequacy filings and analysis for product growth opportunities.
Develops product growth & expansion strategy through research and data analysis for a 1-3 year growth plan.

Medica's Product Manager III supports Medicare, Dual Eligible, and Individual and Family lines of business.


Qualifications:
Bachelor's degree or equivalent experience in related field
5 years of work experience beyond degree

Additional Experience, Skills and Abilities:
Project Management experience and able to lead meetings to identify/track Provider contracting progress toward Medicare/QHP product project growth goals
Experience leading cross functional projects
Experience working in healthcare or insurance industry
Proficient with Excel
Knowledge of Medicare/QHP products
Knowledge of Medicare/QHP process and/or network adequacy requirements
Ability organize and analyze data
Attention to detail, yet see the big picture
Ability to interpret/translate regulatory guidance for functional areas
Ability to establish and maintain strong business relationships at multiple levels of an organization
Ability to adapt to change and work independently
Strong organizational skills with understanding needs required to meet regulatory deadlines
Experience in with Quest Analytics software

This position is a Hub role, which requires an employee to occasionally come onsite to the Minnetonka or Madison office, for applicable heads-up work.

Frequency is determined by business need as decided by leadership.

The full salary range for this position is $75,300 - $129,000.

Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data.

In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.

Medica's commitment to diversity, equity and inclusion (DEI) includes unifying our workforce through learning and development, recruitment and retention.

We consistently communicate the importance of DEI, celebrate achievements, and seek out community partnerships and diverse suppliers that are representative of everyone in our community.

We are developing sustainable programs and investing time, talent and resources to ensure that we are living our values.

We are an Equal Opportunity/Affirmative Action employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

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