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J189151

Product Consultant - Medicare

Gateway Health Plan

  • Company Medicaid And Medicare Advantage Plan
  • Pittsburgh, PA
  • Product Development
  • Full time
  • Day (United States of America)

Company :

Gateway Health Plan

Job Description : 

JOB SUMMARY

This job directs all phases of product- related strategic and non strategic projects, product development and distribution within the assigned product line. Provides oversight on several interrelated products on the total process/design from product inception through administration and market implementation. Coordinates all aspects of product management including regulatory compliance, legal considerations, operations, communications, marketing, etc … across the entire organization The incumbent oversees business and system integration. Directs product strategy and assure the product activities are in alignment with product vision and corporate strategy. Products and programs may include but are not limited to medical, pharmacy, clinically based, and wellness and prevention offerings, and non-medical based offerings. Manages initiatives involving internal and external constituents (e.g. vendors, IDN, providers, diversified services) as necessary to ensure successful delivery of new products and programs from ideation through launch. Provides subject matter expertise to the department and enterprise as required.

ESSENTIAL RESPONSIBILITIES

  • Perform research on projects and manage and lead projects to successfully meet business objectives. May manage all size projects (small, medium, large, enterprise)
  • Prepare detailed design specifications, coordinate and oversee implementation of new products and changes to existing products.
  • Identify needs to develop new and innovative products, perform appropriate research/analyses, and evaluate feasibility of the administration and implementation of product.
  • Monitor product performance and make product design changes where appropriate.
  • Provide direction and guidance to ensure consistent understanding and implementation of specifications.
  • Provide business training on existing products as well as training on product changes. Provide subject matter expertise and consultation for product management.
  • Review all campaigns and initiatives and make appropriate recommendations for improvement.
  • Provide Subject Matter Expertise consultation for product management.
  • Other duties as assigned or required.

EDUCATION

Required

  • Bachelor's Degree in Business, Marketing, Finance or Healthcare

Substitutions

  • None

Preferred

  • Master's Degree

EXPERIENCE

Required

  • Work experience in Healthcare, Insurance and/or Product Management and Development

Preferred

  • 3-5 years of Medicare experience (Product, CMS Regulations, and or familiarity with CMS filings (application and or CMS bid))
  • Experienced in various operational roles (vendor management, claims, membership, etc.) that will further enhance and identify critical needs for product implementations
  • Experience interpreting clinical trends to help design and manage benefits
  • Strong presentational skills, ability to articulate, prepare presentations for key messaging and recommendations at executive levels

LICENSES AND CERTIFICATIONS

Required

  • None

Preferred

  • None

SKILLS

  • Advanced analytic skills consisting of business analysis experience
  • Microsoft Office products

Languages (Other than English)

None

Travel Requirement

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Non-Office based

Teaches/trains others regularly

Frequently

Travel regularly from the office to various work sites or from site-to-site

Frequently

Works primarily out-of-the office selling products/services (sales employees)

Does Not Apply

Physical work site required

No

Lifting: up to 10 pounds

Rarely

Lifting: 10 to 25 pounds

Rarely

Lifting: 25 to 50 pounds

Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf )

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For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

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