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.
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