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Director of Medicare Advantage Product Development

3 months ago

Wilmington, North Carolina, United States Johns Hopkins Medicine Full time

Job Summary

The Director of Medicare Advantage Product Development for Johns Hopkins HealthCare will lead the development for growth and product strategies for the Medicare Advantage lines of business.

Role Accountabilities Include:

  • Responsible for product/benefit strategies, competitive analysis, state and federal regulatory filings, benefit design, and annual filings of benefits (Bid)
  • Ensure the product offerings achieve corporate goals and adjust program to drive performance while keeping our Medicare Advantage Product competitive
  • Ensure corporate approval for the filings and performance projections
  • Collaborate annually with the Actuarial team to develop competitive and financially sound benefit filings.
  • Partner with Sales and Marketing to manage and deliver services to include:
    • Market segmentation
    • Enrollment forecasting
    • Go-to-market strategy
  • Partner with Health Services and Provider contracting to ensure the program designs and network meet customer expectations and market demands.
  • Responsible for vendor relations associated with selecting, contracting, and evaluating benefit vendors
  • Responsible for RFP development and response in relation to all products and services incorporated in Medicare Advantage Benefit Plan

Qualifications:

  • Bachelor's degree in health administration, business, or a closely related field required. Advanced coursework and/or Master's degree desirable
  • 10+ years' experience in Medicare Advantage/Managed Care/Health Insurance understanding Medicare Advantage business and financial drivers, product development, and federal and state regulatory requirements.
  • Strong market knowledge of Medicare Advantage/Medicare with solid understanding of Medicare Advantage revenue and cost drivers
  • Requires strong knowledge and exposure to Federal and State health care regulations, Medicare Advantage industry and managed care industry, including a working knowledge Medicare.
  • Professional level of knowledge of business, administrative, consulting, healthcare marketing and management theory
  • Demonstrated leadership and team building skills
  • Ability to effectively and professionally interact with diverse groups of people including senior leadership, high level external contacts, members, providers, business related associates and vendors
  • Proven project management skills
  • Negotiation skills
  • Advanced knowledge of standard PC Word, PowerPoint, Excel

Many organizations talk about transforming the future of healthcare, at Johns Hopkins Health Plans, we are setting the pace for change within the healthcare industry. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for our members and the communities we serve. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home.

Please note: US citizenship is required for this position as it falls under the terms of a government contract (to ensure compliance with DODPSP).