Director, Product Implementation - Medicare & Commercial

What you can expect! 

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!

Under the direction of the Senior Director of Commercial Products, the Director, Product Implementation - Medicare & Commercial, will lead the annual product renewal and implementation projects to support the Medicare D-SNP and Covered California lines of business. Key duties include the development of detailed project plans, oversight of activities from impacted functional areas, and responsible for the delivery of capabilities and products needed for Open Enrollment and targeted Go-Live date.  This position will work closely with Division and Department Leaders in the development of product/capability requirements, timeframes, and success measures.  The Director, Product Implementation - Medicare and Commercial will ensure products’ adherence with Federal and State regulations, contractual and licensing requirements, and the Plan’s functional departments business requirements. 

Key Responsibilities

1. Lead annual product implementation activities for Medicare and Commercial (Covered California) which will include managing the delivery of critical capabilities, and define configuration requirements and system changes, and meet all required business and regulatory time frames.
2. Oversee the development of a consolidated project plan, with detailed business requirements from all impacted functional teams.
3. Work with Division and Department leaders across the organization to ensure appropriate resources are assigned to support planning and implementation phases of new or enhanced benefits, products, programs, or pilot projects.
4. Collaborate with stakeholders to track project progress, risks, and facilitates cross-functional solution development.
5. Provide detailed project reporting and other communications as needed, to Division and Department leaders.
6. Deliver required member-facing regulatory documents for all required channels (print, website, portals) within required time frames.
7. Identify potential risks, project charge, and scope. Recommend in design of appropriate mitigation and contingency plans. Support in identifying best practices to drive product integrity, service excellence, and efficiency. 
8. Support capabilities to support member retention and new member enrollment during the Medicare Annual Enrollment Period and Covered California Open Enrollment. Ensure Sales, Marketing, delegated vendors and front-line teams have timely access with benefit trainings, explanation of benefit design, member materials, sales and marketing collateral, talking points and program education, configuration and benefit display requirements.
9. Build and manage a team to support business needs, including recruiting, training, and coaching Team Members.
10. Lead a team to reflect IEHP’s Vision, Mission, and Values, ensuring focus on the member and effective collaboration with other business partners.
11. Any other duties as required ensuring Health Plan operations are successful.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.

• CalPERS retirement
• 457(b) option with a contribution match
• Generous paid time off- vacation, holidays, sick
• State of the art fitness center on-site
• Medical Insurance with Dental and Vision
• Paid life insurance for employees with additional options
• Short-term, and long-term disability options
• Pet care insurance
• Flexible Spending Account – Health Care/Childcare
• Wellness programs that promote a healthy work-life balance
• Career advancement opportunities and professional development
• Competitive salary with annual merit increase
• Team bonus opportunities

Education & Experience

• A minimum of eight (8) years of experience in managed care and project management.  Experience with health plan operations. Experience working within a matrix structure to deliver results. Strategic planning experience with demonstrated success in implementing and managing complex projects, while leading cross functional collaborative teams. Proven leadership experience, mentoring, and developing a team at a leadership level.
• Bachelor’s degree from an accredited institution required.

Key Qualifications

• Knowledge of managed care, health plan operations, and regulatory and compliance requirements for Medicare D-SNP and Covered California.  Working knowledge of IEHP’s D-SNP, Medi-Cal, and Covered California products.
• Excellent interpersonal and motivational skills. Excellent organizational skills.  Excellent communication skills both verbal and written.  Project management skills. Microsoft Office programs including, but not limited to, Word, Excel, PowerPoint, and Outlook.
• Proven ability to:
  • Collect, analyze and recommend solutions using data and experience driven decisions.
  • Work in a complex, rapidly evolving environment which requires high-level initiative.
  • Make quick adjustments to project deadlines or assignments.
  • Work independently and collaboratively within a team environment.
  • Effectively prioritize and manage multiple projects with competing deadlines.
  • Apply knowledge and guide self.
  • Negotiate and resolve complex and sensitive issues with diplomacy and persuasiveness.
  • Interact effectively at all levels of an organization.
  • Possess attention to detail.

Start your journey towards a thriving future with IEHP and apply TODAY!

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