VP, Medicare Product

Job Summary:

Reporting to Senior Vice-President of Government Programs, the VP Product is responsible for designing products and strategic planning for Medicare products (Medicare Individual, Group and Duals) across markets. This leader will work closely with internal partners (including Sales and Marketing, Clinical Operations, Actuarial/Finance, Strategy) to launch and refine competitive Medicare products. This role will require a deep understanding of the actuarial drivers of the product and how to build a competitive Medicare product. The VP of Medicare Product will oversee all aspects of product planning on a county by county and segment by segment level basis including county level analytics, and detailed market research to competitively design and implement each Plan Benefit Package. This role will be responsible for developing the go-to-market strategy for each product in partnership with Marketing. The selected individual will demonstrate experience in leadership, strategic planning and organizational, operational, and technical skills, and customer relationship management. This role will need to demonstrate excellent oral and written communications through organizing, running and participating in meetings and work teams, analysis and report generation, correspondence, and preparing and delivering presentations. The VP is also responsible for the creation and timely, accurate, and compliant distribution of all required pre and post enrollment product material and ensures a successful annual product implementation. The Vice President will closely partner with the Market Regional Presidents to understand the key drivers of Medicare Advantage Product performance including drivers related to the care delivery model and network relationships. This role is expected to lead cross functional teams within the National Health Plan and partner with teams across the organization including actuary, finance, marketing, Permanente Medical Groups, and Market teams to design competitive products.

• Own planning, strategy design and development of Medicare Product which includes Direct Pay Medicare (Medicare Advantage Prescription Drug Plan, Medicare Supplement Plans, Prescription Drug Plans) and Group Medicare.
• The VP of Medicare Product oversees all aspects of product planning including county level analytics, and detailed market research to competitively design and implement each Plan Benefit Package.
• Own the portfolio of efforts and initiatives to ensure sustainable growth for Medicare products. Key responsibilities include the development of each Plan Benefit Package and related analytics, market research for development of each product, product rebalancing, member communication, age-in conversion, and ensuring employer group Medicare product goals are met.
• The VP of Medicare Product will closely partner with leadership teams across the organization including finance, clinical operations, sales/marketing, analytics, and actuarial services to competitively position our Medicare products that align with regional objectives and delivery system objectives for growth, quality, and margin.
• Strategically align product development priorities to identify, assess, and make adjustments for competitive product designs, pricing, and benefits.
• Lead and manage Medicare ancillary product strategy, diversification, innovation, development, and implementation.
• Oversee implementation of state and federal benefit mandates, including benefit and member communications requirements.
• In partnership with Government Relations, support the business relationship with regulators, including local Division of Insurance (DOI), and the Centers for Medicare and Medicaid Services (CMS).
• Ensure timely submission of fully substantiated rate and policy bid and form filings to CMS and DOI.
• Drive business targets through influential leadership models with key business partners throughout the organization. Represent Medicare Line of Business in various leadership forums.

• Minimum twelve (12) years of health care leadership experience.
• Minimum ten (10) years experience managing Medicare Advantage Product.
• Minimum ten (10) years experience using actuarial insights to develop competitive MA bids.

• Bachelor’s degree in business administration, public health or related field.

• N/A

• Exemplary work history with a proven record of success in positions of progressively greater responsibility managing people and achieving business goals and objectives.

• 6-10 years of business experience in Medicare and/or FEP Product Development or Management.
• MBA, Master’s degree in business administration, public health, administration or related field, preferred.