Medicare Compliance and Product Management Lead

3 days ago


New York, New York, United States NYC Health Hospitals Full time

About This Opportunity

NYC Health + Hospitals seeks a highly skilled Product Specialist, Integrated Products to join our team. In this role, you will provide analytical support and project management expertise to drive the successful implementation of Integrated Medicare lines of business.

Key Responsibilities

  • Support the Senior Manager of Medicare in overseeing Integrated Plans and vendor operations, ensuring alignment with strategic goals and regulatory requirements.
  • Develop and maintain product dashboards to track product and branding effectiveness.
  • Analyze data to provide insights on Integrated Products operations, including membership, benefits, market trends, claims, and oversight.
  • Provide project management support for the successful completion of projects, including Integrated Products implementation and coordination of CMS model materials.
  • Identify and implement performance improvement initiatives for Integrated Products and address issues and resolutions.
  • Communicate regulatory changes, new product/program implementations, and special projects to stakeholders.
  • Serve as a liaison between multiple stakeholders to ensure clear and consistent communication and cross-functional solutions meet product requirements.
  • Collaborate with operational departments to develop workflows, issue logs, and project plans to meet product requirements.
  • Contribute to the development of policies and procedures and other product-specific documentation.
  • Partner with operational departments to research and identify root cause issues and evaluate solutions related to product.
  • Respond to internal and external requests for data, information, and statistics related to regulatory and product reporting activities.

Requirements

  • Bachelor's degree from an accredited college or university in an appropriate discipline required.
  • Minimum 4 years of experience in Medicare Managed Care, preferably with a Health Plan, in a compliance/regulatory/legal/product/operations or project management role.
  • Minimum 1 year of experience managing complex projects, including complex product development processes.
  • Experience in developing and monitoring operational dashboards and KPIs to ensure operational effectiveness.
  • Demonstrated ability to manage workplans and hold stakeholders accountable.
  • Demonstrated ability to manage multiple deliverables simultaneously and meet compliance timelines.
  • Experience in managing projects and partnering with cross-functional teams.
  • Excellent analytical skills, demonstrated by significant ability to pull data, analyze complex data sets, and present in consumable reports/presentations to management.
  • Facility with MS Office, including Excel/Access/Visio required.
  • Experience using reporting tools & software, such as SQL, SAS, Tableau preferred.

Estimated Salary: $95,000 - $130,000 per annum, depending on location and experience.



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