Product Manager, Medicaid

Education: A minimum of a Bachelor's Degree in Business, Health Care Administration, or closely related field is required. A Master's degree or seven to ten years of experience in administering health insurance programs product management is strongly desirable.

Experience: Experience and expertise in new product development, product management, marketing and sales and/or strategic planning with a 'track record' of tangible success, including leadership and team collaboration/relationship-building/management in a health care or related environment is essential. Direct extensive knowledge and experience with government programs, particularly Medicaid legislation and program content is required. Familiarity with understanding and communicating complex and contradictory state and federal law, regulations or guidance is also required.

Key Skills/Competencies:

• Ability to think strategically (big picture) yet manage projects at a very detailed level
• Project Management, requirements gathering and ability to prioritize continually/multi-task
• Leadership and ability to communicate a compelling vision for the program/products
• Comfortable with a matrix environment
• Ability to build and manage relationships
• Critical thinking/Problem-solving
• Judgment and Decision-making
• Initiative and creativity
• Negotiation Skills and Conflict Resolution/Management
• Communication Skills (written, verbal/presentation and active listening)
• Teamwork/Collaboration
• Customer-Centric Skills, and ability to understand internal and external customers
• Understanding and coping with constant change

Job Summary: Position can be filled in Appleton, Wisconsin, Madison, Wisconsin, Austin, Texas, Phoenix, Arizona, or Remote.

The Medicaid Program Manager (MPM) will be responsible for coordinating and supporting the development, sales and execution of managed Medicaid program and products. The MPM provides expert support for all aspects of program strategy and operations. The MPM assesses program capacity and capabilities for managing new clients, directs and manages the implementation of new CMS and State Medicaid program requirements and oversees SME support. The MPM is responsible for staying abreast of and understanding industry, marketplace, and legal developments, their impact on the business and translating current and emerging market needs into product expansion/enhancement or new product concepts/business cases. The MPM will work with all key functional areas to ensure quality product development and on-going support of the Sales and Client Services departments to support 'sell-in' of the products. The MPM is the 'voice of the customer' and leads the process of maintaining and improving products, and developing new ones. In addition, the MPM has full P&L (profit and loss) responsibility for the program/products, including forecasting, sales RFPs and finalist presentations, pricing, training, and gathering, interpreting and relaying customer requirement and feedback.

This role requires strong technical writing skills, deep knowledge of Medicaid regulations and a deep knowledge of both the technical and marketing sides of the program.

Job Responsibilities:

• Provides direction on product development for managed Medicaid products and defines the structure for supporting multiple managed Medicaid clients.
• Assesses program capacity and capabilities for managing new clients and oversees SME support of initial and annual client implementations, key business functions, processes and the departments supporting managed Medicaid.
• Coordinates functions and communications throughout the organization as a 'hub' to ensure the successful delivery of the Medicaid program for managed care clients.
• Monitors CMS and State Medicaid program regulations, guidance, and systems to determine needs and gaps that impact growth, financial or operational performance.
• Stays abreast of and understands industry, marketplace, and legal developments and their impact on the business. Translates current and emerging market needs into product expansion/enhancement or new product concepts/business cases.
• Assists Navitus in attaining and maintaining a deep understanding of Medicaid.
• Directs and manages the implementation of new CMS and State Medicaid program requirements and transfers operational ownership to the appropriate Navitus department once implementation is complete.
• Develops program performance goals including membership, data and processing quality, profitability, and compliance and oversees program monitoring and reporting.
• Full P&L (profit and loss) responsibility for the program/products, including forecasting sales; training; gathering, interpreting and relaying customer feedback; and working closely with Finance to establish product pricing strategies including base pricing, maintenance and support, and value-added services.
• Ensures Medicaid program and products meet all regulatory requirements.
• Supports Sales force with expertise, training and sales tools, as well as assistance in establishing managed Medicaid partnerships, RFPs responses and finalist presentations.
• Provides direction and oversight for the development, modification and improvement of business processes and policies.
• Develops and continually improves strategies, objectives and policies for the Medicaid program. and identifies and resolves any issues that may hinder program success.
• Develops strong relationships with key internal and external stakeholders and decision makers.