Product Specialist (Hybrid) - Health Insurance Plan Management

What We Provide

• Referral bonus opportunities
• Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
• Employer-matched retirement saving funds
• Personal and financial wellness programs
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
• Generous tuition reimbursement for qualifying degrees
• Opportunities for professional growth and career advancement
• Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities

What You Will Do

• Supports product management team in the development of benefit and competitive analysis.
• Develops a strong understanding of all VNS Health Plans strategic business objectives and business unit operations in order to support the end-to-end product life cycle for one or more VNS Health Plans products. Participates in the development, design, readiness and implementation of new products and benefits. Identifies and recommends changes to improve existing products. Retires products and benefits at end of life and/or per regulatory changes.
• Keeps abreast of external environment (competitor offerings, NYS DOH & CMS regulations, coalition/affiliation group positions, provider network, membership needs) to identify new opportunities and requirements for VNS Health Plans products.
• Analyzes processes and systems to ensure compliance with contractual agreements, NYS DOH & CMS regulations. Works with Compliance to evaluate new regulations and assists with operationalizing where necessary. Participates in program audits to ensure product and program compliance.
• Collects and analyzes data through dashboards and other sources to monitor product performance against defined goals and criteria; identifies root causes and trends. Summarizes findings and identifies/documents opportunities for improvement. Works with functional partners to develop strategies to improve results.
• Recommends and implements efficient means of data collection, management and analysis.
• Summarizes and communicates findings with users and recommends solutions to address user concerns.
• Supports the development of Medicaid and Medicare product vision by performing in depth analysis of membership and enrollment, quality programs, RAF, improvement metrics, etc.
• Manages all phases of a project from concept through implementation. Develops project plans and Gantt charts which includes defining requirements/scope, tasks, work assignments, resources and project milestones. Monitors project progress through completion, addressing risks and issues; reports/escalates issues appropriately. Advises project sponsor of status and potential risks.
• Conducts formal presentations to key stakeholders of varying audiences and levels of the organization. Provides guidance around new processes as needed. Initiates training as necessary.
• Participates in the review of member and provider facing written and digital content, such as member handbooks, member letters, website, social media channels, provider manuals, reference guides, presentation materials, flyers, etc.
• Works with Marketing in the review of acquisition materials, communications and collateral to ensure it is supportive of the brand and position.
• Supports Product Management team operational and administration functions including vendor contracting, management of vendor invoices and purchase orders against budget and oversight of subcontractor reporting.
• Participates in special projects and performs other duties as assigned.

Education:
Bachelor's Degree in Business Administration, Healthcare Administration, statistics, epidemiology, mathematics, computer science or social sciences, or related field of study required

Master's Degree in related field preferred

Work Experience:
Minimum two years of business analysis or product management experience in a managed care health care organization required

Experience with data extraction and manipulation required Intermediate to advanced level of proficiency with data modeling and analytics required

Proficiency with MS Excel functions, including macros, pivot tables, filtering and formatting required Proficiency with Microsoft Office required including PowerPoint, Visio and MS Project required

Experience with SQL or PL/SQL preferred. Familiarity with Medicaid and Medicare regulations required Experience with claims data and health plan quality metrics (e.g., HEDIS, QARR) and application of general linear models and other estimation techniques to identify risk, stratify populations, and/or predict outcomes preferred

Effective oral, written and interpersonal communication skills required

Demonstrated strong analytical, project management and presentation skills required