Medicaid Insurance Product Manager

San Antonio, Texas, United States

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Not SpecifiedCompensation

Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Health Insurance, MedicaidIndustries

Requirements

Candidates must possess a Bachelor's degree in healthcare, business administration, or a related field, coupled with over 3 years of experience in Medicaid and Dual Eligible product management. A strong understanding of health plan coverage and benefit design, proven ability to interpret regulatory guidance, and experience with agile delivery and project management are essential. Proficiency in Microsoft Office Suite and demonstrated success in cross-functional collaboration are also required, alongside excellent communication skills and a growth mindset.

Responsibilities

The Senior Insurance Product Manager will act as a strategic partner to Medicaid Market teams, enhancing member and market experiences through consumer-centric products and educating associates on benefit delivery. Responsibilities include translating regulatory guidance into actionable product designs, communicating product details to stakeholders, conducting consumer research, monitoring industry trends, analyzing benefit performance, and collaborating with various teams to develop value-added benefits. The role also involves leading benefit filing processes, providing subject matter expertise, supporting communications, and mentoring junior team members.

Skills

Medicaid

Product Management

Benefit Design

Consumer Research

Regulatory Guidance

Market Analysis

Strategic Planning

Problem-Solving

Communication

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters

1961Year Founded

IPOCompany Stage

Social Impact, HealthcareIndustries

10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.

Rising medical costs and tightening Medicare reimbursements may strain financial performance.

Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.

The company emphasizes inclusivity, offering free language interpreter services for accessibility.

Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.

The company is the first insurer to cover TMS therapy for adolescent depression.

Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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