Medicaid Insurance Product Manager

Become a part of our caring community and help us put health first
 

Humana Medicaid is seeking exceptional candidates to join our Medicaid Product Organization to support the strategic direction and growth of the Medicaid and Duals lines of business. This is a unique opportunity for a motivated individual to influence the mission of a leading healthcare company committed to improving the health of the communities it serves.

We are a diverse set of highly skilled people with deep Medicaid subject matter expertise who work in an agile, collaborative environment. To achieve our goals, we empower associates to pioneer simplicity, rethink routine and seek talent with the following attributes:
• Creative – Adept at research to determine the opportunity and a structured yet flexible approach to problem solving.
• Adaptive - Rapidly learn new knowledge, skills, and behaviors in response to changing circumstances.
• Self-sufficient - Ability to navigate complex situations and independently produce high quality deliverables.
• Consultative – Build/sustain relationships and inform the work of others through actionable, objective insights.
• Strategic – Forward thinking capable of providing frameworks to maximize available resources to achieve growth.

The Medicaid Insurance Product Manager plays a critical role in developing and managing Medicaid and Dual Eligible insurance products and services that meet the needs of Humana’s customers while aligning with its business objectives. Responsibilities include:  

• Translate requirements and guidance from federal and state government to define health plan covered service packages and eligible cohorts.
• Manage Market client relationships and support their business goals and growth by providing benefit insights and customized services.
• Communicate covered services and relevant insurance product information to operational partners, ensuring the information is organized, complete, and accurate.
• Understand Humana Medicaid and Dually Eligible Customers by researching their needs and pain points and designing consumer centric, easy to use benefits, while remaining responsive to both State and Federal requirements and goals. 
• Analyze industry trends and the marketplace to ensure Humana benefits remain attractive.
• Evaluate benefit performance to develop data driven insights to inform benefit design.  
• Collaborate with market leaders and various operational teams (clinical, population health, network, finance and actuary) to help deliver value added benefit, incentives, and In lieu of Service packages that delight key customers and support sustainable health plan operations.
• Lead product and benefit filing efforts with the regulatory agencies in a timely and compliant manner ensuring that Humana benefits remain administered and delivered.
• Provide subject matter expertise to investigate and resolve escalated benefit inquiries and complex benefit-related issues.
• Deliver benefit education and training to associates.
• Supply benefit related information to support the development of accurate internal and external facing communications.
• Provide written and verbal communication to executive level leadership. Clearly deliver pertinent data to inform effective decision making to advance product strategy.
• Serve as a mentor and leader to junior level positions on the team and work collaboratively to ensure Humana Medicaid product is operating as intended.

Use your skills to make an impact
 

Required Qualifications

• Bachelor’s Degree.
• 3+ years of related work experience with Medicaid and/or Duals products and services.
• 2+ years of successful project management experience.
• Working knowledge of health plan product coverage and benefit concepts.
• Strong attention to detail with a proven ability to accurately identify and interpret regulatory and contractual guidance.
• Adept at performing competitor analysis to synthesize the marketplace and produce actionable insights.
• Experience working collaboratively across multiple functional areas (e.g. operations, provider network, contracting) and fostering teamwork.
• Excellent communication skills (written, oral and presentation skills).
• Ability to use data and analytical thinking to make fact-based decisions and/or recommendations.
• Advanced proficiency in Microsoft Office applications, including Word, Excel, and PowerPoint.

Preferred Qualifications

• MPH, MBA, or similar higher-level education.
• Clinical operations and medical coding experience.
• Proven ability to bring new benefits to market with experience/training in agile delivery and project management.
• Strong Financial Acumen.
• Experience designing benefit packages to help with winning RFP responses.

Work at Home Requirements

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Additional Information:

• Workstyle: Hybrid Office if you live within commuting distance of our office location in Louisville, KY; Remote if you live outside of commuting distance of Louisville, KY.
• Travel: Up to 10% to office location in Louisville, KY.
• Core Workdays & Hours: Typically, Monday – Friday 8:00am – 5:00pm Eastern Standard Time (EST).
• Benefits: Benefits are effective on day 1. Full time Associates enjoy competitive pay and a comprehensive benefits package that includes 401k, Medical, Dental, Vision and a variety of supplemental insurances, tuition assistance and much more.....  

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by Hire Vue, a third-party vendor.  This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview.  If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided.  Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$86,300 - $118,700 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline: 02-27-2025

About us
 

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.