Product Manager Health Plan - HP Product Management

Summary:

At the direction of the Director of Product Management, CHRISTUS Health Plan (CHP), the Product Manager – Health Plans (Product Manager) will provide a collaborative link between business strategy, operations and technology teams, by designing, implementing and maintaining health insurance products that help to achieve overall business objectives and goals. The Product Manager will work with stakeholders to prioritize and implement product and system enhancements to increase operational efficiencies, maintain regulatory compliance and increase the covered lives to the CHRISTUS Health System. This role ensures products are competitive, compliant with federal and state regulations, financially sustainable, and aligned with member and market needs

Responsibilities:

• Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• Keeps informed of both federal and state regulatory changes that impact operations and works with business stakeholders and technology partners to establish the best path to compliance.
• Represents CHRISTUS Health Plan with the regulatory agencies for the product and performs as the subject matter expert on technical and multi-stakeholder industry collaborations, such as the Health Plan Alliance and other industry groups.
• Provides leadership, product expertise and support for initiatives related to product development, compliance, operational and process improvements, claims management, vendor management, product documentation, fulfillment, and/or system releases.
• Collaborates with business stakeholders to establish, support and maintain member-facing functions and tools that enhance the member experience, improve member retention, and reduce operational overhead.
• Defines, tracks and communicates key product and financial performance indicators as required to track business results.
• Works with key stakeholders to make frequent and dynamic prioritization decisions based on the latest product information and product team metrics.
• Works within the product budget established in consultation with business sponsors and product management by balancing resources across the product team, but primarily to sustain product teams to deliver and enhance the product.
• Performs and assists in designing quantitative studies of trends in the supported products, benefits, plan performance on the Risk Adjustment, HEDIS Measures, CMS’s Five-Star Quality Ratings System, NCQA Plan Rating System, different population performance, and other product strategic initiatives and goals.
• Ensures the delivery team is prepared to perform and service the product before and after the launch of a product.
• Acts as the "keeper (and communicator) of the vision" to translate the product strategy and vision developed with business stakeholders into what the operational and technology teams must bear in mind every day to ensure they are fulfilling the requirements of the product.
• Works closely with product operational and technology teams to ensure product objectives and goals are being met.
• Collaborates with other product owners, operational and technology teams to avoid duplication and manage dependencies.
• Coordinates with other stakeholders such as ministry leadership, data and IT architects to align product and platform architectures and capabilities according to agreed goals.
• Performs other tasks as required or assigned.

Requirements:

Education/Skills

• Bachelor’s degree in business or related field required
• Master’s Degree Business Administration or related field preferred
• Direct experience with ACA Individual Marketplace products required
• Strong knowledge of ACA regulations and CMS filing requirements required
• Experience working with actuarial pricing and financial modeling concepts required
• Strong analytical skills required
• Demonstrated cross-functional leadership skills required
• Experience with risk adjustment and reinsurance programs preferred
• Knowledge of state-based exchanges vs. federally facilitated marketplace models preferred
• Familiarity with SERFF rate filing preferred
• PMP or Product Management Certification preferred

Experience

• 5 or more years of experience in the health insurance or healthcare industry preferred

Licenses, Registrations, or Certifications

• None required

In accordance with the CHRISTUS Health License, Certification and Registration Verification Policy, all Associates are required to obtain the required certifications for their respective positions within the designated time frame.

Work Schedule:

5 Days - 8 Hours

Work Type:

Full Time