Product Manager Government Programs (Hybrid/Troy, MI) - Health Alliance Plan
🔍 Troy, Michigan
GENERAL SUMMARY:
This position is responsible for providing independent program oversight for HAP’s Medicaid/Medicare products. This includes the development of the Medicaid/Medicare product strategies, informing and coordinating activities for the operations and sales of the Medicaid/Medicare Product; partnering with other departments on the development and implementation of specific strategies to streamline processes, enhance member satisfaction, enhance growth and increase member retention of the Medicaid/Medicare product. This position will have responsibility to interface with governmental bodies relative to plan rules and regulations and overall impact for the product.
PRINCIPLE DUTIES AND RESPONSIBILITIES:
- Lead and direct cross-functional activities that provide effective oversight of Medicaid/Medicare Programs, including overseeing the implementation of new or revised program requirements and ensuring that accountable departments have fully implemented and put into practice policies, procedures and processes to meet CMS and other regulatory agency guidelines.
- Act as the conduit for HAP for notices from DIFS, MI Dept of Health and Human Services and CMS relative to program management and filings. Attend meetings with the State as a representative of the plan and ensure that the information presented in the meetings is communicated back to the plan in a timely and accurate manner.
- Work with stakeholders to develop and implement strategies for Medicaid/Medicare membership growth and retention. Track and report on product performance and progress against goals.
- Collaborate with Compliance Officer and Compliance Committee to ensure policies and procedures comply with contractual and regulatory requirements.
- Lead annual process to determine upcoming year benefits, pricing, service area expansion, etc. Gather data necessary for bid, working with Underwriting, Actuaries, Sales, Pharmacy, Network Development, Healthcare Management, Compliance and other areas as appropriate.
- Coordinate and lead work teams to implement benefit changes. This includes filings for benefit changes, service area expansion, contract revisions, annual bid, etc., as well as IT for benefit configuration and operational areas for assessment of operational impacts.
- Participate in workgroups for AHIP and CMS. Attend annual training and conferences.
- Disseminate industry updates and competitive information regarding Medicaid/Medicare products internally.
- Coordinate and oversee operational opportunities to improve product financial performance.
- Perform other related duties as assigned.
EDUCATION/EXPERIENCE REQUIRED:
- Bachelor’s Degree in a related field.
- Master’s degree preferred.
- Minimum of three (3) years of experience with Medicaid and/or Medicare programs, specific experience in Medicare/Medicaid Dual Programs preferred.
Minimum of five (5) years of experience in a managed care, health care, health plan clinical or financial administration environment, which includes experience with Medicaid and Medicare health insurance programs. - Demonstrated leadership experience required.
- Strong knowledge of government health insurance programs.
- Strong analytical, creative problem solving, facilitation, critical thinking and decision-making skills.
- Excellent program and project management skills including planning, prioritizing and problem solving.
- Excellent communication skills - written, verbal, presentation and interpersonal.
- Excellent ability to multi-task, influence and negotiate.
- Excellent ability to work in a fast paced changing environment.
- Commitment to service excellence.
- Respect for diversity.
- Ability to work in collaboration with groups and work teams.
- Team spirited.
Overview
HAP is a Michigan-based, nonprofit health plan that provides health coverage to individuals, companies and organizations. A subsidiary of Henry Ford Health System, we partner with doctors, employers and community groups to enhance the overall health and well-being of the lives we touch. With more than 1,100 dedicated and passionate employees, our goal is to make health care easy for our members.
Under the leadership of President and CEO Robert G. Riney, Henry Ford Health is a
$6 billion integrated health system comprised of six hospitals, a health plan, and 250+ sites
including medical centers, walk-in and urgent care clinics, pharmacy, eye care facilities and
other healthcare retail. Established in 1915 by auto industry pioneer Henry Ford, the health system
now has 32,000 employees and remains home to the 1,900-member Henry Ford Medical Group, one
of the nation’s oldest physician groups. An additional 2,200 physicians are also affiliated with the
health system through the Henry Ford Physician Network. Henry Ford is also one of the region’s
major academic medical centers, receiving between $90-$100 million in annual research funding and
remaining Michigan’s fourth largest NIH-funded institution. Also an active participant in medical
education and training, the health system has trained nearly 40% of physicians currently practicing
in the state and also provides education and training for other health professionals including nurses,
pharmacists, radiology and respiratory technicians. visit HenryFord.com.
Benefits
Whether it's offering a new medical option, helping you make healthier lifestyle choices or
making the employee enrollment selection experience easier, it's all about choice. Henry
Ford Health System has a new approach for its employee benefits program - My Choice
Rewards. My Choice Rewards is a program as diverse as the people it serves. There are
dozens of options for all of our employees including compensation, benefits, work/life balance
and learning - options that enhance your career and add value to your personal life. As an
employee you are provided access to Retirement Programs, an Employee Assistance Program
(Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness
and access to day care services at Bright Horizons Midtown Detroit, and a whole host of other
benefits and services. Employee's classified as contingent status are not eligible for benefits
Equal Employment Opportunity/Affirmative Action Employer
Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health System is
committed to the hiring, advancement and fair treatment of all individuals without regard to
race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,
weight, marital status, family status, gender identity, sexual orientation, and genetic information,
or any other protected status in accordance with applicable federal and state laws.