AVP, Medicare Product Development
Molina Healthcare
Job Description
Job Summary
This position is responsible for supporting development and pricing of Medicare products, which include today MMP, D-SNP and MA-PD, with additional products on the horizon for 2020 and beyond.
Knowledge/Skills/Abilities
The AVP, Medicare Product Development is a key member of a national support team that is responsible for significantly contributing to Medicare strategy and growth. The position 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 position is the lead liaison for the Medicare department 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 presenting strategic product development updates to senior leaders.
Additional duties include the following:
1. 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.
2. Engages VPs of government contracts at health plans to obtain feedback and direction on MMP benefits.
3. Coordinates with the national contracting team to ensure vendor contracts are aligned with product design and approved bids and pricing.
4. Reviews vendor contracts for dental, vision, transportation, etc. to ensure optimal rates and service.
5. Leads the development of supplemental rider benefits plans.
6. Leads QA process of Medicare and MMP PBP uploads to ensure accurate filing of intended plan designs.
7. Leads Competitive Analysis function to inform current and future year planning..
Job Qualifications
Job Summary
This position is responsible for supporting development and pricing of Medicare products, which include today MMP, D-SNP and MA-PD, with additional products on the horizon for 2020 and beyond.
Knowledge/Skills/Abilities
The AVP, Medicare Product Development is a key member of a national support team that is responsible for significantly contributing to Medicare strategy and growth. The position 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 position is the lead liaison for the Medicare department 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 presenting strategic product development updates to senior leaders.
Additional duties include the following:
1. 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.
2. Engages VPs of government contracts at health plans to obtain feedback and direction on MMP benefits.
3. Coordinates with the national contracting team to ensure vendor contracts are aligned with product design and approved bids and pricing.
4. Reviews vendor contracts for dental, vision, transportation, etc. to ensure optimal rates and service.
5. Leads the development of supplemental rider benefits plans.
6. Leads QA process of Medicare and MMP PBP uploads to ensure accurate filing of intended plan designs.
7. Leads Competitive Analysis function to inform current and future year planning..
Job Qualifications
Required Education
BA/BS or equivalent experience
Required Experience
Seven years + Medicare Advantage product development expertise, including direct experience with product develop and Bids.
Preferred Education
Graduate degree in related field
Preferred Experience
Preferred experience in Duals program is desirable.
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.
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