Humana Medicaid Senior Insurance Product Manager - Santa Fe, New Mexico
Become a part of our caring community and help us put health first
Humana Medicaid is seeking exceptional candidates to join our Medicaid Product Strategy Organization to support the strategic direction and growth of the Medicaid and Duals lines of business. This is a unique opportunity for a motivated individual to influence the mission of a leading healthcare company committed to improving the health of the communities it serves.
We are a diverse set of highly skilled people with deep Medicaid subject matter expertise who work in an agile, collaborative environment. To achieve our goals, we empower associates to pioneer simplicity, rethink routine, and seek talent with the following attributes:
- Creative: Adept at research to determine the opportunity and a structured yet flexible approach to problem solving.
- Adaptive: Rapidly learn new knowledge, skills, and behaviors in response to changing circumstances.
- Self-sufficient: Ability to navigate complex situations and independently produce high-quality deliverables.
- Consultative: Build/sustain relationships and inform the work of others through actionable, objective insights.
- Strategic: Forward-thinking capable of providing frameworks to maximize available resources to achieve growth.
The Medicaid Senior Insurance Product Manager plays a critical role in developing and managing Medicaid and Dual Eligible insurance products and services that meet the needs of Humana's customers while aligning with its business objectives. Responsibilities include:
- Translate requirements and guidance from federal and state government to define health plan covered service packages and eligible cohorts.
- Communicate covered services and pertinent insurance product information to operational partners, ensuring information is organized, complete, and accurate.
- Understand Humana Medicaid and Dually Eligible Customers by researching their needs and pain points and designing consumer-centric, easy-to-use benefits while remaining responsive to both State and Federal requirements and goals.
- Analyze industry trends and the marketplace to ensure Humana benefits remain attractive.
- Evaluate benefit performance to develop data-driven insights to inform benefit design.
- Collaborate with market leaders and various operational teams (clinical, population health, network, finance, and actuary) to design value-added benefit and In lieu of Service packages that delight key customers and support sustainable health plan operations.
- Lead product and benefit filing efforts with the regulatory agencies in a timely and compliant manner ensuring that Humana benefits remain administered and delivered.
- Provide subject matter expertise to investigate and resolve escalated benefit inquiries and complex benefit-related issues.
- Supply benefit-related information to support the development of accurate internal and external facing communications.
- Provide written and verbal communication to executive-level leadership.
- Clearly deliver pertinent data to inform effective decision-making to advance product strategy.
- Serve as a mentor and leader to junior level positions on the team and work collaboratively to ensure Humana Medicaid product is operating as intended.
Use your skills to make an impact
Required Qualifications
- Bachelor's Degree in an appropriate area of knowledge (e.g., health care, business administration, etc.)
- Working knowledge of health plan product coverage and benefit concepts.
- Strong attention to detail with a proven ability to accurately identify and interpret regulatory and contractual guidance.
- Adept at performing competitor analysis to synthesize the marketplace and produce actionable insights.
- Experience working collaboratively across multiple functional areas (e.g., operations, finance, clinical, actuary, configuration) and fostering teamwork.
- Excellent communication skills (written, oral, and presentation skills).
- A growth mindset who thrives on taking on new challenges and embraces working in a fast-paced changing environment.
- Ability to use data and analytical thinking to make fact-based decisions and/or recommendations.
- Advanced Proficiency in Microsoft Office applications, including Word, Excel, and PowerPoint.
Preferred Qualifications
- MPH or MBA or similar higher-level education.
- Clinical operations and medical coding experience.
- Proven ability to bring new benefits to market with experience/training in agile delivery and project management.
- Experience designing benefit packages to help with winning RFP responses.
- Minimum of 3+ years of related work experience with Medicaid and Duals products and services.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full-time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job-related skills, knowledge, experience, education, certifications, etc. $76,800 - $105,800 per year. This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental, and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance, and many other opportunities.
About us
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay, or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity, or religion. We also provide free language interpreter services. See our accessibility resources.
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