Director, Medicare Product Development
Molina Healthcare Job ID 2025414JOB 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.
Pay Range: $87,568.7 - $189,732.18 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type: Full Time Posting Date: 04/22/2024ABOUT OUR LOCATION
View Map- Tribal Liaison (Billing & Claims) Remote in New Mexico Albuquerque New Mexico, Ruidoso New Mexico, Grants New Mexico, Gallup New Mexico, Santa Fe New Mexico, Taos New Mexico, Farmington New Mexico, Roswell New Mexico, Hobbs New Mexico, Las Cruces New Mexico 03/16/2024
- Manager, Appeals & Grievances United States, Louisville Kentucky, Kentucky 03/15/2024
- Telephonic Case Manager (RN) - CA licensed and Bilingual spanish required California, Imperial Beach California 04/05/2024
- Bilingual Community Connector (Spanish) Remote in Southern Cal Los Angeles California, San Bernardino California, Ontario California, Long Beach California, Imperial Beach California, Riverside California, San Diego California 05/04/2024
No recently viewed jobs.
View All JobsNo saved jobs.
View All Jobs