Associate Product Manager, Medicaid and Exchange

Role Overview

• Leads tactical product development efforts and provides oversight of daily operations required to support the Medicaid and Exchange product
• Leads the annual retro-eligibility ranking process for Exchange clients, working closely with Technical Operations to ensure timeliness and completeness
• Develops general subject matter expertise related to State Medicaid requirements for member materials, IT, third party liability, 340B, rebates, and reporting
• Provides Medicaid/Exchange SME support to Implementation Team for new client implementations and coordinates the process for implementing new plan benefit design changes that occur after initial implementation.
• Works closely with the ADMEO for the annual Exchange QHP application/certification process
• Coordinates the development, implementation, and maintenance of Medicaid/Exchange software processes and interfaces for all managed Medicaid clients and Exchange clients.
• Leads the Exchange JSON file delivery requirement
• Ensures the Exchange function meets all regulatory requirements.
• Works closely with functional teams to ensure that appropriate processes are being adhered to in order to comply with Exchange program requirements
• Supports readiness assessments, data validation efforts and client and/or regulatory audits
• Tracks, monitors, analyzes, and reports product performance goals including data and processing quality, mandated reports, and compliance.
• Leads Federal Exchange “Transparency in Coverage” annual reporting requirements/processes
• Develops, modifies, and improves business processes and policies needed to support the Medicaid/Exchange program

Requirements

• A minimum of a bachelor’s degree in Business, Health Care Administration, or closely related field is desired
• Experience and expertise in supporting operational projects with a “track record” of tangible success, including team collaboration/relationship-building is essential.
• Knowledge and experience with government programs, particularly Medicaid/Exchange products content desired
• Participate in, adhere to, and support compliance program objectives
• The ability to consistently interact cooperatively and respectfully with other employees.

Benefits

• Top of the industry benefits for Health, Dental, and Vision insurance
• 20 days paid time off
• 4 weeks paid parental leave
• 9 paid holidays
• 401K company match of up to 5%
• No vesting requirement
• Adoption Assistance Program
• Flexible Spending Account
• Educational Assistance Plan and Professional Membership assistance
• Referral Bonus Program – up to $750!