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Director, Medicare Product Development job

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Molina Healthcare

Job Ref:  2025414
Employer:  Molina Healthcare
Sector:  Health Insurance
Qualifications:  Senior Qualified Actuary
Job Type:  Full Time
Salary and Benefits:  $87,568 - $189,732 per year
Remote:  No

Location

Country:  United States
Post Code:  Not specified
Map: 

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.

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: 04/22/2024
ref: (2025414)
Applied = 0
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