Start: Jan 3, 2022 | Duration: 26 Weeks
The Product Solutions Specialist II is focused on providing end to end development and management for product line initiatives. This position is focused on applying technical healthcare contract expertise in performing in the development and management of product line initiatives.
This position supports contract-related inquiries, initiatives, and projects that support the overall product strategy and lifecycle. Works closely with leadership and participate in cross functional groups. Responsible for identifying product management best practices,. Identify impacted parties, business partners, and resources required. Collaborate and support in implementing best practices cross functionally.
Recommend and participate in the design of processes and product requirements that support business needs. Designs methods for integrating function and processes including applicable dependencies inclusive of enterprise initiatives. Identify risk and help troubleshoot resolution of issues.
Participate in the Product Development Lifecycle and or initiatives through the management of contracts and regulatory filings. Collaborate with leadership to develop the regulatory filing schedule for cycle documents. Prepare and ensure regulatory filing documents according to timeline. Support all product contracts regarding benefits, quality performance measures, penalty risks, etc.
Monitoring of the tactics for compliance/contractual requirements. Develop the technical product requirements according to contractual obligations to ensure compliance. Facilitate the coordination of responses from partners for ad-hoc requests and develops responses according to established timeline.
Facilitate effective cross-functional meetings to adequately support new strategic implementations. Primary contact for technical requirements, development and execution. Develop a sustainable and repeatable process for the technical adaptation and validation of product initiative. Evaluate and support the remediation efforts of member grievance or plan partners.
Perform other duties as assigned.
At least 3-5 years of Commercial Medicare/Medi-Cal Product Experience (Product & Benefit knowledge) and of California Health Insurance Exchange (Covered CA)/Centers for Medicare and Medicaid Services (CMS)/Department of Health Care Services (DHCS) requirements experience.
Education Required: Bachelor's Degree In lieu of degree, equivalent experience may be considered
Knowledge of product strategy. Knowledge of product management and strategic planning and packaging concepts.