Associate Product Manager, Medicaid and Exchange
Navitus Health Solutions
full-time
Posted on:
Location Type: Remote
Location: Alaska • Hawaii • United States
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Salary
💰 $61,968 - $74,660 per year
About the role
- Leads tactical product development efforts and provides oversight of daily operations required to support the Medicaid and Exchange product
- Leads the annual retro-eligibility ranking process for Exchange clients, working closely with Technical Operations to ensure timeliness and completeness
- Develops general subject matter expertise related to State Medicaid requirements for member materials, IT, third party liability, 340B, rebates, and reporting
- Provides Medicaid/Exchange SME support to Implementation Team for new client implementations and coordinates the process for implementing new plan benefit design changes that occur after initial implementation.
- Works closely with the ADMEO for the annual Exchange QHP application/certification process
- Coordinates the development, implementation, and maintenance of Medicaid/Exchange software processes and interfaces for all managed Medicaid clients and Exchange clients.
- Leads the Exchange JSON file delivery requirement
- Ensures the Exchange function meets all regulatory requirements.
- Works closely with functional teams to ensure that appropriate processes are being adhered to in order to comply with Exchange program requirements
- Supports readiness assessments, data validation efforts and client and/or regulatory audits
- Tracks, monitors, analyzes, and reports product performance goals including data and processing quality, mandated reports, and compliance.
- Leads Federal Exchange “Transparency in Coverage” annual reporting requirements/processes
- Develops, modifies, and improves business processes and policies needed to support the Medicaid/Exchange program
Requirements
- A minimum of a bachelor’s degree in Business, Health Care Administration, or closely related field is desired
- Experience and expertise in supporting operational projects with a “track record” of tangible success, including team collaboration/relationship-building is essential.
- Knowledge and experience with government programs, particularly Medicaid/Exchange products content desired
- Participate in, adhere to, and support compliance program objectives
- The ability to consistently interact cooperatively and respectfully with other employees.
Benefits
- Top of the industry benefits for Health, Dental, and Vision insurance
- 20 days paid time off
- 4 weeks paid parental leave
- 9 paid holidays
- 401K company match of up to 5% - No vesting requirement
- Adoption Assistance Program
- Flexible Spending Account
- Educational Assistance Plan and Professional Membership assistance
- Referral Bonus Program – up to $750!
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
product developmentdata validationregulatory compliancebusiness process improvementperformance trackingreportingsoftware process implementationJSON file deliveryMedicaid requirementsExchange program requirements
Soft Skills
team collaborationrelationship-buildinginterpersonal communicationcooperative interactionrespectful communication
Certifications
bachelor's degree in Businessbachelor's degree in Health Care Administration