Senior Director, Products

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!

Reporting to the Chief Operating Officer, the Senior Director of Products is responsible for the quality, compliance, and operational performance of IEHP's Commercial and Medicare Advantage products, including but not limited to the California Health Benefit Exchange plans and a Dual Eligible Special Needs (DSNP) plan. This position ensures products and services brought to the market are competitive and financially sustainable. The Senior Director serves as a subject matter expert, thought leader, and internal consultant for IEHP Executives and Departments. The incumbent delivers best-in-class performance while driving IEHP's product, pricing, and growth strategies ensuring product initiatives are aligned with IEHP's Mission, Core Values, and strategic priorities.

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, but we also aim to match our team members with the same energy by providing prime benefits and more.

• Competitive salary.
• Hybrid schedule.
• State of the art fitness center on-site.
• Medical Insurance with Dental and Vision.
• Life, short-term, and long-term disability options
• Career advancement opportunities and professional development.
• Wellness programs that promote a healthy work-life balance.
• Flexible Spending Account – Health Care/Childcare
• CalPERS retirement
• 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance

1. Lead the product development, management, and implementation of commercial and Medicare products. Partner with the Executive Leadership Team to ensure product and pricing strategies meet the organization’s strategic priorities. This includes collaboration with IEHP leaders to meet Quality, risk adjustment, retention, Network, Member Experience, etc. objectives.
2. In collaboration with the Vice President of Strategy, determine the overall growth goals of commercial and Medicare products, short-term and long-term strategies and roadmaps.
3. Define and monitor product and operational KPIs/performance metrics, drive problem solving, and root-cause analysis to systematically improve and sustain efficient operations. Spearhead continuous process and product performance improvements to meet changing regulatory, market, consumer, and provider demands. Ensure rigor and discipline in product lifecycle management, successfully completing the annual re-certification and CMS bid submission process.
4. Provide exemplary health care industry expertise, successfully integrate new growth opportunities into the organization and its operations, identify key areas of risks in product initiatives, build mitigation plans and drive results. When required, drive end-to-end product lifecycle for new products, program and/or service offerings across all lines of business.
5. Provide technical guidance, consultation, and recommendations for improvement of the organization's policies, procedures, and practices for all products. Ensure appropriate and timely implementation of requirements through the continuous review of current industry trends, practices, regulations, applicable laws, and legislation.
6. Interface and serve as the organization's liaison with regulatory agencies and governmental agencies for the organization's commercial and Medicare products.
7. Provide regular updates and feedback on the status of product initiatives to Executives Leadership and impacted Team Members. Facilitate quarterly meetings with Executives and Leadership to ensure adequate understanding of accomplishments, risks, and barriers of current and newly identified initiatives.
8. Meet and communicate regularly with functional teams to resolve issues and manage negative trends with particular emphasis on Marketing, Sales, Enrollment, Member Services, Care Management, Provider Services, and Claims.
9. Provide direct leadership, oversight, and accountability for the annual renewal and implementation projects for commercial and Medicare Advantage products. Develop a consolidated annual workplan including, but not limited to, key project milestones, regulatory deliverables, training & development objectives, and actions focused on readiness for open enrollment and new benefit year changes.
10. Cultivate and maintain positive working relationships at all levels of the organization to ensure positive collaboration to identify, assess, and prioritize upstream and downstream impacts of the commercial and Medicare product initiatives throughout the organization.
11. Hire, train, and manage support staff, while monitoring and evaluating outcomes. Conduct performance reviews of each Team Member within IEHP guidelines.
12. Perform any other duties as required to ensure Health Plan operations and department business needs are successful.

Education & Requirements 

• A minimum of ten (10) years of progressive experience in a leadership position within a health plan administration function, including a minimum of five (5) years of experience in a leadership role in commercial and Medicare Advantage markets and product development in a managed care setting
• Demonstrated experience with:
  • ACA and Medicare Advantage health plan operations
  • Covered CA or similar state-based health benefit exchange, both implementation and sustainment
  • Taking a commercial or Medicare Advantage product from inception, design concept to market launch and stabilization
  • Contracting, implementing, and managing Third Party Administrator or external vendors, including developing and managing service level agreements
  • Working with brokers to achieve membership, margin, and market-share targets
  • Bachelor’s degree from an accredited institution required
    • Master’s degree from an accredited institution preferred

Key Qualifications

• Advanced knowledge and deep understanding of:
  • Managed care, government programs, or other product lines 
  • Healthcare, health plans and/or health plan accreditation principles and practices, in directing operations within the organization
  • Regulatory and compliance requirements related to commercial products, including but not limited to the California Knox-Keene Healthcare Service Plan Act and Regulations
  • Health plan operations in a commercial plan environment
  • Competitive landscape to develop market strategies
  • Excellent interpersonal skills with a proven ability to interact effectively at all levels of the organization
  • Excellent communication skills; verbal and written
  • Excellent organization, process, and project management skills
  • Strong organizational skills and attention to detail
  • Excellent analytical skills with emphasis on utilization data to drive operational performance and financial performance
  • Quantifying impact and ROI of initiatives preferred
• Proven ability to:
  • Implement change in a consultative approach and maneuver in a matrix reporting environment
  • Work independently and collaboratively within a team environment and matrix management structure to deliver results
  • Manage multiple products within a commercial health plan and multiple projects with competing deadlines and changing priorities with proven execution against aggressive objectives
  • Partner with external partners to execute goals and initiatives of the organization
  • Work in a complex, rapidly evolving environment which requires high-level initiative, and judgment necessary to bring resolution to sensitive issues
  • Communicate effectively to a variety of audiences in small or large group settings

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

This position is on a hybrid work schedule. (Mon & Fri - remote, Tues - Thurs onsite in Rancho Cucamonga, CA.)