[Remote] Senior Medicaid & Duals Insurance Product Manager at Humana

San Antonio, Texas, United States

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

Bachelor’s degree in healthcare, business administration, or a related field
Minimum of 3+ years of experience in Medicaid and Dual Eligible product management
Ability to drive process optimization, improve efficiency and deliver measurable outcomes
Experience in ensuring regulatory and operational compliance in cross functional environments
Strong understanding of health plan coverage and benefit design
Proven ability to interpret regulatory and contractual guidance with precision
Experience conducting competitive analysis and synthesizing market insights
Demonstrated success in cross-functional collaboration
Excellent written, verbal, and presentation communication skills
Growth mindset with a passion for innovation and continuous improvement
Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint)
Background in agile delivery and project management

Responsibilities

Serve as a strategic partner to Medicaid Market teams, supporting growth through tailored benefit insights and services
Enhance member and market experiences by delivering impactful, consumer-centric products
Lead the product lifecycle for assigned markets—from strategic planning through go-to-market execution
Deliver ongoing client support by designing and implementing scalable, operationally sound solutions
Educate and empower associates to ensure effective benefit delivery
Translate contracts and regulation requirements into actionable product and operational strategies
Organizing market research including analyzing industry trends and assessing strengths and weaknesses of competitors
Ensure effective and compliant implementation of benefits across internal and external stakeholders
Analyze benefit performance and generate data-driven insights to inform product strategy
Collaborate cross-functionally with clinical, financial, actuarial, and operational teams to design, administer and deliver benefits and services
Lead benefit filing processes with regulatory agencies, ensuring timely and compliant submissions
Provide subject matter expertise to resolve complex benefit-related issues and inquiries
Support the creation of accurate internal and external communications related to benefits
Mentor junior team members and foster a collaborative, high-performance culture

Skills

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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