Director, Medicare Product Development

Found in: beBee S US - 2 weeks ago


Long Beach, United States Molina Healthcare Full time
Job Description

JOB DESCRIPTION

Job Summary

This position is responsible for supporting development and pricing of Medicare products, which include MA-PD, D-SNP and MMP.

KNOWLEDGE/SKILLS/ABILITIES

The Director Medicare Product Development is a key member of a small team that is responsible for significantly contributing to Medicare strategy and growth. The product development department is the Company's go to expert for all matters relating to Medicare product development, including meaningful difference, benefits uniformity, TBC and what services constitute benefits under Medicare and SNP guidance. The director conducts research and helps the department liaison with marketing, sales, and the national contracting team. The position works with the actuarial department and applies automated tools to determine actuarial cost of changes in cost share and formularies for HMO and PPO MA-PD products and makes recommendations on benefit design including drug list to senior leadership. The position is responsible for preparing competitive market analysis reports for current and future markets and preparing strategic product development updates for senior leaders.

Additional duties include the following:
  • Works with the actuarial department to determine the cost of making changes in benefits design for dental, vision, OTC, transportation, and other benefits that cater to dual eligible.
  • Engages VPs of government contracts at health plans to obtain feedback and direction on MMP benefits.
  • Coordinates with the national contracting team to ensure vendor contracts are aligned with product design and approved bids and pricing.
  • Reviews vendor contracts for dental, vision, transportation, etc. to ensure optimal rates and service.
  • Leads the development of supplemental rider benefits plans.
  • Leads QA process of Medicare and MMP PBP uploads to ensure accurate filing of intended plan designs.

JOB QUALIFICATIONS

Required Education

BA/BS or equivalent experience

Required Experience

Five years + Medicare Advantage general experience, including familiarity with product development and bids

Preferred Education

Graduate studies

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

  • Long Beach, United States Molina Healthcare Full time

    Job DescriptionJob DescriptionJob Summary Molina Segment leaders are responsible for the development and administration of Segment specific departments, programs and services, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulatory requirements. Job Duties ...


  • Long Beach, United States Molina Healthcare Full time

    Job DescriptionJob DescriptionJob Summary Molina Medicare Stars Program Manager functions oversees, plans and implements new and existing health care quality improvement initiatives and education programs. Responsible for Medicare Stars projects and programs involving enterprise, department or cross-functional teams of subject matter experts, delivering...


  • Long Beach, United States CareerBuilder Full time

    The Business Development Director is responsible for hospital inpatient and outpatient census in the IRF and/or LTCH and mix through the design and implementation of referral programs and customer service strategies. This position oversees inpatient admission process. The Business Development Director manages, trains and develops hospital-wide Business...


  • Long Beach, United States Designory Full time

    **JOB SUMMARY**: The Director of Business Affairs is a Senior role in handling business management duties which include handling usage, license, invoicing and any clearances needed on a video or still image production/project. Understands and plays a key role with managing third party materials and usages for the agency. **Schedule**:Hybrid - In office 3...


  • Long Beach, United States Designory Full time

    **JOB SUMMARY**: The Director of Business Affairs is a Senior role in handling business management duties which include handling usage, license, invoicing and any clearances needed on a video or still image production/project. Understands and plays a key role with managing third party materials and usages for the agency. **Schedule**: Hybrid - In office 3...


  • Long Beach, United States Designory Full time

    Job DescriptionJob DescriptionSalary: JOB SUMMARY:The Director of Business Affairs is a Senior role in handling business management duties which include handling usage, license, invoicing and any clearances needed on a video or still image production/project. Understands and plays a key role with managing third party materials and usages for the...


  • Long Beach, United States Business & Pleasure Co. Full time

    MAJOR RESPONSIBILITIES (Position Summary)Business and Pleasure is seeking a Product Development Associate to assist in the production of a variety of outdoor consumer products. This is a new position on our growing team, and will report directly to the Senior Product & Design Manager in our LA office. The Product Development Associate will be responsible...

  • Product Development Associate

    Found in: Appcast Linkedin GBL C2 - 1 week ago


    Long Beach, United States Business & Pleasure Co. Full time

    MAJOR RESPONSIBILITIES (Position Summary)Business and Pleasure is seeking a Product Development Associate to assist in the production of a variety of outdoor consumer products. This is a new position on our growing team, and will report directly to the Senior Product & Design Manager in our LA office. The Product Development Associate will be responsible...


  • Long Beach, United States Molina Healthcare Full time

    **Job Description** **Job Summary** Telesales role. Responsible for taking and making telephone calls with prospective members with the intent to educate them on benefits of Molina products and then conducts enrollment into product of choice over the phone or other sales enrollment channel desired. + **Shift available-11:30 am - 8 pm pst time...


  • Long Beach, United States Lakeshore Learning Materials Full time

    In a time of unprecedented expansion, were looking for a Senior Product Developer to join our RD&D New Product Development team. This role is responsible for the end-to-end ideation, development, and launch of educational products. The ideal candida Developer, Product Development, Product, Senior, Technology, Retail, Skills

  • Sales Executive

    2 days ago


    Daytona Beach, United States Florida Health Care Plans Full time

    Sales Executive - Individual ACA & Medicare Membership Growth and Retention Full-time 1st shift Monday- Friday 8am-5pm POSITION SUMMARY: The Sales Executive will sell products and services to individuals under 65 seeking a marketplace plan. This role will also sell FHCP Medicare products to individuals who are Medicare eligible and are turning 65. The Sales...


  • Long Beach, United States Beach Front Property Management Full time

    Job Type Full-time Description Seeking a seasoned Director of Training and Development with a deep expertise in property management. With over 8 years of industry experience, this role demands a leader ready to design and implement transformative training programs that elevate our team's capabilities and align with our strategic goals. If you have a strong...


  • Long Beach, United States Hiresigma Full time

    Job Description Job Description TITLE- Director of Credit, Global Operations (Hybrid) CITY- Long Beach, CA Must-Haves SaaS Credit Experience/Expertise GAAP knowledge and experience IFRS knowledge and experience Policies development experience for global SaaS Job Description The Director of Credit, Global Operations plays a vital role in overseeing and...


  • Union Beach, United States Rehabilitation Center Inc Full time

    Position: Admissions Director Position We are seeking an exceptional and dynamic individual to join our team as the Admissions Director at our Union Beach, NJ facility. The Admissions Director plays a pivotal role in our organization. In this capacity, you will engage with hospitals and various referral resources in a timely and discreet manner. Your...

  • Director of Production

    Found in: Appcast Linkedin GBL C2 - 3 weeks ago


    Hallandale Beach, United States 1ST Full time

    Position: Director of Production, 1/STLocation: Hallandale Beach, FL (On-Site) About the Company: 1/ST is a world-class racing and gaming operator, entertainment curator and real estate development company. As the largest racing and wagering company in North America, we process over $13B in annual wagers, connect with 5M customers and host some of the...


  • Long Beach, United States Hiresigma Full time

    Job DescriptionJob DescriptionTITLE- Director of Credit, Global Operations (Hybrid)CITY- Long Beach, CAMust-HavesSaaS Credit Experience/ExpertiseGAAP knowledge and experienceIFRS knowledge and experiencePolicies development experience for global SaaSJob DescriptionThe Director of Credit, Global Operations plays a vital role in overseeing and developing the...


  • Long Beach, United States Molina Healthcare Full time

    Job Description Job Summary Molina Health Plan Operations jobs are responsible for the development and administration of our State Health Plan's Operational departments, programs and services, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local...

  • Director Front Office

    Found in: beBee S US - 7 days ago


    Long Beach, United States Hotel Queen Mary Full time

    Job SummaryAs a Director of Front Office you would be responsible for directing and administering of all Front Desk operations in the hotel's continuing effort to deliver outstanding guest service and financial profitability. Provides assistance with rooms financial reporting as needed and provides directional support and guidance to the property Guest...

  • Director of MDS

    Found in: Lensa US P 2 C2 - 21 minutes ago


    West Palm Beach, United States HC&N Healthcare Solutions Full time

    Director of MDS A nursing home is seeking a Director of MDS. The Director of MDS is responsible for the overall successful completion of the MDS process from admission to discharge in accordance to company policy and procedure, State and Federal guidelines, and all other appropriate entities. Responsibilities and Duties: Ensure collection of resident...

  • Legislative Director

    Found in: Talent US C2 - 2 weeks ago


    Long Beach, United States The California State University Full time

    Position Information The California State University, Office of the Chancellor, is seeking a  Legislative Director  to play a key role in leading the Office of Federal Relations’ efforts to make the CSU a thoughtful, effective and significant voice in the nation’s capital on higher education policy and spending, and on any other matters directly...