Director of Product Management - Medicare/Medicaid - AlohaCare

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Director of Product Management - Medicare/Medicaid

AlohaCare is a local, non-profit health plan serving the Medicaid and Medicare dual eligible population. We provide comprehensive managed care to qualifying health plan members through well-established partnerships with quality health care providers and community-governed health centers. Our mission is to serve individuals and communities in the true spirit of aloha by ensuring and advocating access to quality health care for all. This is accomplished with emphasis on prevention and primary care through community health centers that founded us and continue to guide us as well as with others that share our commitment. As Hawaii’s third-largest health plan, AlohaCare offers comprehensive prevention, primary and specialty care coverage in order to successfully build a healthy Hawaii.

The Culture:

AlohaCare employees share a passion for helping Hawaii’s most underserved communities. This passion for helping and caring for others is internalized and applied to our employees through a supportive and positive work environment, healthy work/life balance, continuous communication and a generous benefits package.

AlohaCare’s leadership empowers and engages its employees through frequent diversity, recognition, community, and educational events and programs. AlohaCare has a strong commitment to support Hawaii’s families and reinforces a healthy work/home balance for its employees. Because AlohaCare values honesty, respect and trust with both our internal and external customers, we encourage open-door, two-way communication through daily interactions, employee events and quarterly all-staff meetings. AlohaCare’s comprehensive benefits package includes low cost medical, dental, drug and vision insurance, PTO program, 401k employer contribution, referral bonus and pretax transportation and parking program.

These employee-focused efforts contribute to a friendly, team-oriented culture which is positively reflected into the communities we serve.

The Opportunity:

Product management guides every step of a product's lifecycle and unites product development and sales. The Director of Product Management provides leadership and direction for Product Management and Sales for all lines of businesses. This position directs departmental staff and ensures cross-functional engagement on business plans, performance metrics and key initiatives. This position is accountable for building a high performance, values driven culture for the Product Management and Sales teams. This role is an analytical thinker who drives performance improvement through metrics, is mindful and committed to the AlohaCare mission and partnerships needed to accomplish organizational goals. Creates a culture of learning, performance, inclusion, health and giving back to the community. Maintains a collaborative partnership with the External Affairs team to ensure our Product, Marketing, and Advertising strategies are aligned.

General Duties and Responsibilities:

• Collaborate with leadership team to design, develop, implement, and manage products from initial conception through service delivery.
• Develop and execute annual Medicare Sales Road Map, Annual Sales Plan, defining the objectives, key performance and results and related budget, in close collaboration with key stakeholders (Media & Communications, External Affairs and other stakeholders).
• Monitor market trends to identify new product opportunities (e.g. supplemental benefits) or enhancements to existing products.
• Manages and oversees all aspects of assigned products and programs (including supplemental and optional benefits) such as policy, direction, design, coordination, and evaluation of product performance.
• Develops strong relationships with key internal and external stakeholders including but not limited to key departments, providers, Community Based Organizations, Community Health Centers, Hawaii’s Med-QUEST Division, Department of Health, Centers for Medicare and Medicaid Services, and others.
• Responsible to maintain AlohaCare’s confidential information in accordance with AlohaCare policies, and state and federal laws, rules, and regulations regarding confidentiality. Employees have access to AlohaCare data based on the data classification assigned to this job title.

Specific Responsibilities

Product Management

• Responsible for ensuring that all business functions are adequately trained and prepared to service and deliver the product according to operational guidelines and/or contractual requirements.
• Regularly monitors and reviews product performance and addresses identified opportunities to optimize product performance.
• Supports all aspect of the annual Medicare Bid design, preparation, and submission; and AlohaCare’s response to Medicaid Request for Proposals (RFPs).
• Serves as subject matter expert for all product lines, member population, as well as the special challenges in rural Hawaii and neighbor islands.
• Ensures legal and regulatory compliance of new products and product enhancements.
• Leads and/or oversees new system, product, and business implementations.
• Responsible for leading & driving top line revenue strategies for Medicare sales.
• Responsible for keeping apprised of market trends, market share movement and ongoing competitive analysis.
• Supervises Sr. Manager of Sales & Business Development to lead, motivate and optimize sales team and broker performance while ensuring regulatory compliance.
• Designs and improves sales incentive programs.
• Develop and implement sales revenue maximization plans for all segments & channels (that lead to increased market share).
• Responsible for achieving organizational sales goals and deploying strategic initiatives for the recruitment and retention of SNP members.
• Fosters strategic alignment of internal and external partnerships in support of sales goals.

Required Qualifications:

• Bachelor’s degree in a related field
• 5 years in Medicaid and/or Medicare programs
• 5 years of experience in multiple operational areas
• 5 years of management experience
• Proven track record for implementing strategic improvements & prioritizing activities based on impact
• Substantial and sustained demonstrated experience successfully planning, organizing, managing and implementing Executive level and cross-functional projects
• Expertise in Medicaid & Medicare regulations and best practices
• Working knowledge of managed care operations needed to anticipate downstream impacts of decisions
• Knowledge of public delivery systems, including Community and Rural Health Centers
• Knowledge and experience in dealing with community and cultures in Hawaii

Required Skills:

• Executive demeanor to generate momentum at all levels in the organization
• Excellent oral, written, and interpersonal communication skills
• Ability to effectively communicate with diverse stakeholders including providers, members, government officials, community leaders, media, government officials and employees
• Demonstrated strategic planning, analytical, decision making, and problem-solving ability
• Ability to translate strategy into actionable steps & oversee successful execution

Preferred Qualifications:

• MBA or equivalent advanced degree
• Extensive knowledge of the QUEST (Hawaii Medicaid) program and established relationships with MQD
• Previous experience creating business plans and overseeing the financial performance of products
• Previous experience with CMS’ HPMS and contract oversight processes
• Leadership experience in a non-profit environment & comfort with leading the mission

Mental, Physical and Environmental Demands:

• Sedentary Work: Exerting up to 20 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time.
• Inside working conditions.
• Ability to work independently and prioritize tasks
• Able to travel up to 25% of the time on-island and occasionally to neighbor islands or mainland
• Requires access to own transportation if needed to attend off-site meetings
• Requires operation of general office equipment to include PC.

Salary range: $110,000 - $150,000 annually

AlohaCare is committed to providing equal employment opportunity to all applicants in accordance with sound practices and federal and state laws. Our policy prohibits discrimination and harassment because of race, color, religion, sex (including gender identity or expression), pregnancy, age, national origin, ancestry, marital status, arrest and court record, disability, genetic information, sexual orientation, domestic or sexual violence victim status, credit history, citizenship status, military/veterans status, or other characteristics protected under applicable state and federal laws, regulations, and/or executive orders.