Vice President of Product, Government Programs
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The Role
Reporting to Senior Vice-President of Government Programs, the VP Product is responsible for developing and implementing Medicare and Federal Employee Program (FEP) products that result in achieving membership and margin targets for the Government Line of Business. This leader will work with internal partners (including Sales and Marketing, Actuarial/Finance, Operations, Strategy) to launch profitable Government products and initiatives to meet corporate goals. The VP leads product strategy, product development, annual bid process, Blue-to-Blue conversion (age-in) initiatives. Product portfolio includes: Direct Pay Medicare (Medicare Advantage Prescription Drug Plan, Medicare Supplement Plans, Prescription Drug Plans), Group Medicare, and Federal Employee Program. The position will also be responsible for strategic relationships on the government segments and product operations.
The VP is responsible for strategic Medicare bids and filings. The VP is also responsible for the creation and timely, accurate, and compliant distribution of all required pre and post enrollment product material and ensures successful annual product implementation activities. The Vice President will manage and deploy project management resources as needed to support and ensure that the enterprise technology strategy is consistent with Medicare Product Strategy. The VP leads the development and implementation of the Employer group Medicare product strategy to meet market needs.
Key Accountabilities:
- Direct Medicare Product strategy and portfolio management to ensure profitable growth. Key responsibilities include product rebalancing, product design, member communication, age-in conversion, and employer group Medicare product goals are met.
- Direct product development priorities to identify, assess, and make adjustments for competitive product designs, pricing, and benefits to achieve market leadership.
- Lead and manage Medicare ancillary product strategy, diversification, innovation, development, and implementation.
- Drive profitable membership growth in Government portfolio through development of and/or influence of product, marketing, sales, and operations business plans.
- Lead Medicare Integrated Medicare Market Team (IMMT) to support the development, implementation, and monitoring of an integrated Medicare marketing strategy through collaboration with Marketing, Market Research, Sales, Operations, and Compliance.
- Oversee Medicare Market project management resources and ensure management of all Medicare Management corporate IT projects, including meeting corporate deadlines for material submission.
- Directs the Blue-to-Blue Conversion (Bridge to Medicare) initiatives by collaborating with internal leadership on the development, prioritization, and execution of our Blue-to-Blue goals.
- Lead multi-Blues plan consortium with responsibility of holding a CMS contract for a regional PDP product plus a multi-year contract with a PBM for operational and pharmacy management activities.
- Oversee implementation of state and federal benefit mandates, including benefit and member communications requirements.
- Support the business relationship with regulators, including local Division of Insurance (DOI), and the Centers for Medicare and Medicaid Services (CMS).
- Ensure timely submission of fully substantiated rate and policy bid and form filings to CMS and DOI.
- Negotiate new and existing business relationships with vendors and other Blues plans and oversee the execution, implementation, and oversight of the terms of the contracts, including assigning resources and meeting budget.
- Provide support to and drive business objectives with other key business partners.
- Demonstrate excellent oral and written communications through organizing, running and participating in meetings and work teams, analysis and report generation, correspondence, and preparing and delivering presentations.
- Direct, coach, and mentor a dedicated team of professionals focused on process improvement, cost-effectiveness, and operational efficiency through communication, motivation, teambuilding, leadership, and discipline.
- Work with EVP, SVP and other corporate leaders in business planning, monitoring, and development.
- Maintain a multi-million dollar, non-salaries based, annual budget within target.
- Drive business targets through influential leadership model with key business partners throughout the organization. Represent Medicare Segment in various leadership forums.
- Excellent ability to manage external relationships and performance with vendors necessary to meet business goals. Leads, and participates in, cross-functional meetings with internal business areas and our vendor partners to seek innovative solutions to business concerns, identify efficiencies, and propose business process modeling solutions.
- Provides leadership and mentoring to Medicare product team. Fosters associate and leader loyalty through recognition programs.
Challenges/Problem Solving:
- Lead and drive cross-functional priorities to yield results.
- Develops innovative strategies to support the Medicare Markets business plan and product growth goals.
- Participates in compliance audits and interviews.
- Continuously train the organization on new products and CMS requirements.
- Supports the division in identifying cost savings.
- Develops succession plans.
- Resolves complex problems and issues independently.
Decision Making Authority:
- Single point of accountability on product portfolio development and management.
- Ability to make staffing decisions regarding hiring and terminating employment.
- Assess and determine training, and performance development needs for associates and leaders.
- Enhance and create workflows to meet the changing needs of the business and CMS.
- Ability to coordinate and direct decision-making in complex situations in a fast-paced customer service environment.
- Work requires analytical and regulatory interpretation, independent problem-solving and resolution.
- Implements continuous improvement programs consistent with enhancing operational efficiency, in alignment with the Company’s commitment to quality assurance and continuous improvement methodology.
Leadership Responsibilities:
- Leads and mentors associates, supervisors, and managers within the Medicare Product Management.
- Supports multiple vendor relationships.
- Understands and achieves the goals of our established budget.
- Creates an environment of trust and respect within the unit; fosters team building and acknowledges the successes of others.
- Develops, enhances and implements workflows that support the 5 Star Quality Bonus Program.
- Understands the importance of teamwork and displays commitment to team.
- Leads and facilitates cross-functional teams or initiatives.
Qualifications:
- Demonstrated success and results to lead cross functionally to achieve results and outcomes.
- Strong ability to lead through influence and build key organizational relationships.
- Experience in managing others; demonstrated coaching and mentoring skills.
- Strong presentation skills; ability to effectively communicate the vision and direction of BCBSMA in large groups and meetings.
- Documented strength in data driven approach, identification of problems and problem resolution.
- Strong oral and written communication skills; ability to document and present findings.
- High degree of professionalism and initiative; ability to effectively interact with all levels of an organization.
Education/Relevant Experience:
- MBA or other advanced degree preferred plus 12+ years of health care leadership experience, preferably including 6-10 years of business experience in Medicare and/or FEP Product Development or Management.
- Exemplary work history with a proven record of success in positions of progressively greater responsibility managing people and achieving business goals and objectives.
Minimum Education Requirements:
High school degree or equivalent required unless otherwise noted above.
Location: Boston
Time Type: Full time
Salary Range: $238,950.00 - $292,050.00
The job posting range is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee’s pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability.
This job is also eligible for variable pay.
We offer a comprehensive package of benefits including paid time off, medical/dental/vision insurance, 401(k), and a suite of well-being benefits to eligible employees.
WHY Blue Cross Blue Shield of MA?
We understand that the confidence gap and imposter syndrome can prevent amazing candidates from coming our way, so please don’t hesitate to apply. We’d love to hear from you. You might be just what we need for this role or possibly another one at Blue Cross Blue Shield of MA. The more voices we have represented and amplified in our business, the more we will all thrive, contribute, and be brilliant. We encourage you to bring us your true colors, your perspectives, and your experiences. It’s in our differences that we will remain relentless in our pursuit to transform healthcare for ALL.
As an employer, we are committed to investing in your development and providing the necessary resources to enable your success. Learn how we are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path by visiting our Company Culture page. If this sounds like something you’d like to be a part of, we’d love to hear from you. You can also join our Talent Community to stay “in the know” on all things Blue.
At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing. We provide a flexible hybrid work model in which roles are designated as resident (on site 4-5 days/week), mobile (on site 1-3 days/week), or eworker (on site 0-3 days/month).
About Us:
Voted as the highest in member satisfaction among Massachusetts commercial health plans by JD Power, Blue Cross Blue Shield of Massachusetts is a community-focused, tax-paying, not-for-profit health plan headquartered in Boston. We have been a market leader for over 75 years, and are consistently ranked among the nation's best health plans. Our daily efforts are dedicated to effectively serving our 2.8 million members, and consistently offering security, stability, and peace of mind to both our members and associates.
Our Commitment to You:
We are committed to investing in your development and providing the necessary resources to enable your success. We are dedicated to creating a refreshing and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path. We take pride in our diverse, community-centric, wellness-focused culture and believe every member of our team deserves to enjoy a positive work-life balance.
Blue Cross Blue Shield of Massachusetts is an Equal Employment / Affirmative Action Employer. Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or expression, or any other characteristics protected by law.
Blue Cross Blue Shield of Massachusetts will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with Blue Cross Blue Shield of Massachusetts's legal duty to furnish information.
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