Blue Cross Blue Shield of Massachusetts Product Manager, Medicare in Boston, Massachusetts
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The Product Manager, Medicare will manage day-to-day activities of our Medicare Part D pharmacy benefit plans and Medicare Supplement plans, supporting both direct pay and employer group plans. The Product Manager, Medicare will work collaboratively within a cross-functional business environment to lead successful and compliant implementation of all product offerings. In addition, the Product Manager, Medicare will act as the subject matter expert and will play a key role in the annual processes to file plan benefits and rates to the state and federal government, as well as collaborate with internal and external partners including our pharmacy benefits manager (PBM) to support other go-to-market activities like benefit testing and marketing material review.
Lead activities related to annual bid upload of our Part D plans to the Centers for Medicare & Medicaid Service (CMS), including being proficient in use of CMS bid software and bid upload functions.
Responsible for development, analysis and maintenance of competitive landscape and market position documents and perform research on local and national Medicare marketplace
Lead workgroups for Employer Group segments to implement new plan designs with the pharmacy benefits manager, including development of customized communications
Focus on benefits testing processes for Part D plans within the broader scope of annual go-to-market activities
Focus on detailed review of regulatory and non-regulatory member and marketing materials
Support business reporting needs for product and project implementations; communicate analytical findings to leaders and associates orally and in writing.
Support Product Manager with annual rate filings to the Division of Insurance (DOI) and rate implementation processes; coordinate with key project stakeholders to obtain supporting information required for successful and timely filings
Provide support to Product Managers in the implementation and management of the Medicare product portfolio, including implementation of new state and federal regulatory requirements.
Provide project support for special projects and workgroups as assigned.
Be proficient in utilizing data tools provided through our pharmacy benefit manager which include RxClaim, RxNavigator and Agent Portal.
Act as Medicare subject matter expert providing support to internal business areas like Sales, Account Service and Member Service.
Lead various cross-functional workgroups with pharmacy benefits manager and internal business areas to support day-to-day monitoring activities of our Part D plans, acting as subject matter expert on operational issues and tracking them through resolution.
Qualifications: (Knowledge, skills and abilities)
Experience working in a cross-functional business environment with ability to work closely with both internal and external business partners.
Ability to work independently but within a team environment.
Ability to multi-task and manage multiple deliverables and deliver quality work within agreed upon deadlines.
Ability to demonstrate strong professional presence in situations, meetings and events that involve external companies and require representation from the Product Management team.
Proficiency in primary Microsoft applications including Excel, Access Database and PowerPoint; Data Warehouse reporting experience a plus.
Ability to conduct comprehensive manipulation of data and work with large datasets.
Excellent verbal and written communication skills evidenced by the ability to present information effectively.
Excellent time management and organizational skills.
Work requires analytical interpretation, independent problem solving and resolution.
Knowledge of Medicare program and/or BCBSMA Medicare products preferred.
Prior experience working with pharmacy, medical or other healthcare data preferred.
Bachelor’s Degree or relevant years of experience required
5-7 years of business experience, with preferably 2-3 years in Medicare or health insurance.
Prior experience working with pharmacy or healthcare data preferred.
Industry knowledge of Medicare program and/or Medicare plans a plus.
Pharmacy Benefits Manager (PBM) experience a plus.
Minimum Education Requirements:
High school degree or equivalent required
LocationBostonTime TypeFull time
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).
Blue Cross Blue Shield of Massachusetts, has a COVID-19 vaccination requirement for building entry. Your offer of employment is dependent upon either being fully vaccinated for COVID-19 or an accommodation based on a disability or sincerely held religious belief, practice, or observance by submitting a request to Human Resources.
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.