Product Specialist Health Plan II - HP Product Management in Irving, TX

Job Description

Summary:

The Product Specialist Health Plan II role responsibilities include activities that impact general plan performance and readiness, overall growth, new market entry, member retention, quality program performance, and federal/state filing. The Product Team operates cross-functionally to develop a competitive and differentiated product portfolio and deliver on core business objectives. The Product Specialist II is responsible for translating benefit design requirements into the relevant tools and systems to ensure a successful product design cycle for CHRISTUS Health. This role collaborates with teams across the organization to create the benefit designs and will be a key resource for others in the company to understand our product portfolio. The work directly contributes to the rapid growth and expansion of CHRISTUS Health Plan products.

Responsibilities:

  • Responsible for supporting the benefit design process, producing benefits in the CMS PBP software tool / other regulatory systems (when applicable), and translating benefits into other tools for actuarial/market analysis
  • Supports the annual bid (or review) cycle, working with Actuary, Pharmacy, Delegated Vendors, other Product teams, and operational stakeholders
  • Participate in the development of benefit design recommendations based on competitor analysis and statutory requirements
  • Collaborate with multiple functions at CHRISTUS Health, including actuarial, finance, supplemental benefits, clinical, and marketing teams to ensure a successful product implementation annually.
  • Identifies critical topics for the product strategy and supports efforts to drive decision-making, bringing clarity to sometimes ambiguous situations
  • Facilitates and documents working sessions for Readiness/Implementation Plan with multiple internal stakeholders to develop and operationalize assigned health plans under the product portfolio to ensure success of the product portfolio. This includes preparing agendas, organizing presenters and materials, facilitating discussions, fostering constructive debate to drive to decisions, and identifying and tracking follow-ups.
  • Maintain product benefit source of truth documents with detailed plan design documentation.
  • Assist in the review of materials as they relate to product portfolio, benefits, and cost-sharing
  • Facilitate education and operationalization of benefit design, including claims configuration and benefit interpretation processes
  • Build and maintain key internal and external relationships for successful development, implementation and operation of arrangements related to strategic program goals.

Requirements:

  • Bachelor’s degree in Business or related field
  • Master’s Degree Business Administration or related field, preferred
  • Strong attention to detail and analytical skills; ability to organize and analyze data
  • A strategic thinker and tactical executer who is able to drive results and organizational improvement through performance outcomes
  • Ability to collaborate cross-functionally across departments and various level roles in the organization
  •  Ability to work with culturally diverse groups
  • Four (4) or more years of experience within the healthcare industry required
  • Two (2) or more years of Medicare Advantage product development, bid filing, and PBP creation experience preferred
  • Two (2) or more years of USFHP product management, DHA compliance, and DHA Online Tools. (DEERS & DP Portal)
  • Experience preparing regulatory documents and filings for Federal (CMS or DHA) and State submissions preferred

Work Schedule:

8AM - 5PM Monday-Friday

Work Type:

Full Time


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Job Attributes

Job ID

300636

Job Title

Product Specialist Health Plan II - HP Product Management

Job Type

FULL TIME

Schedule / Shift

8AM - 5PM

Job Category

General Operations

Location

Irving, TX

Product Specialist Health Plan II - HP Product Management

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