JOB SUMMARYThis job will lead our
Utilization Management product management teams including strategy, roadmap formulation, and value realization. This position will partner closely with UM operations and UM product delivery in driving our UM strategy and capabilities. This role will be accountable for leveraging a deep understanding of business and customer problems to solve, market trends, and business goals for defining, developing, and launching products & solutions that meet the evolving needs of our customers, providers, and employees, deliver exceptional experiences and drive business outcomes. The incumbent will be a key driver in shaping the future of our product portfolio and ensuring its alignment with our overall business objectives.
ESSENTIAL RESPONSIBILITIES- Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
- Product Strategy & Vision
- Define and articulate a clear product vision and strategy, communicating it effectively to stakeholders across the organization. Conduct market research, competitive analysis, and customer insights to identify unmet needs and opportunities for product innovation. Apply Human Centered Design principles to develop new products and experiences that delight and create durable customer and business value
- Socialize product strategy and roadmap with key stakeholders and obtain buy-in
- Develop and maintain a comprehensive multi-year product roadmap that aligns with the company's strategic goals and segment/market trends.
- Identify & develop relationships with stakeholders to foster collaboration and influence business strategies & adjust product roadmap & strategy.
- Product Development & Management
- Lead the product development process from ideation to launch, working closely with cross-functional teams including engineering, design, technology, operations, marketing, and sales.
- Define product requirements, user stories, and acceptance criteria, ensuring alignment with experience strategy, business objectives, and customer needs.
- Manage product backlog, prioritize features, and track progress against timelines, budgets, and value realization
- Conduct user testing and gather feedback to continuously improve product usability and performance.
- Product Lifecycle Management
- Monitor product performance metrics, analyze data, and identify areas for improvement.
- Develop and implement strategies for product optimization, growth, and expansion.
- Manage product in accordance with our Product Management lifecycle from launch to sunset, ensuring smooth transitions and minimizing disruption to customers, and engaging appropriate teams (research, design, marketing, engineering) as needed throughout lifecycle.
- Team Leadership & Collaboration
- Build, mentor, and lead a high-performing team of product managers and analysts.
- Develop and deliver messaging that provides clear direction with needed context and strategic connection for teams.
- Foster a collaborative, innovative and data-driven culture within the product team.
- Lead teams through complex organizational or strategic changes with intention and optimism while maintaining team morale.
- Effectively communicate product vision, strategy, and progress to stakeholders at all levels.
- Industry Expertise & Compliance
- Stay abreast of industry trends, regulations, and best practices in the health care sector & ensure comply with relevant regulations and industry standards.
- Other duties as assigned or requested.
EXPERIENCERequired- 7 years of experience in product management, strategy, operational improvement, and/or consulting or other relevant experience, preferably within the health insurance industry.
- 5 years of experience in Management or leadership role
Preferred- UM experience in payer or provider or health tech organization
SKILLS- Through knowledge of membership, rates, financial, economic and competitive data
- Excellent written, interpersonal, communication, and presentation skills
- Excellent analytical, problem-solving, and decision-making skills
- Proven track record of successfully developing and launching innovative products that meet customer needs and drive business growth
- Knowledge of software development lifecycle, from planning to delivery
- Experience developing business cases, and building ROI for programs from planning through execution
- Strong understanding of the health insurance and health system landscape, including regulatory requirements, market dynamics, and customer behavior
- Ability to lead and motivate teams, fostering a collaborative and results-oriented environment
- Experience using sketches, flow diagrams, wireframes, mockups, prototypes, member experience blueprints, and visual concepts
EDUCATIONRequired- Bachelor's degree in Business Administration, Healthcare Administration, or a related field or relevant experience and/or education as determined by the company in lieu of bachelor's degree.
SubstitutionsPreferredLICENSES or CERTIFICATIONSRequiredPreferredLanguage (Other than English):None
Travel Requirement:0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONSPosition TypeOffice- or Remote-based
Teaches / trains others
Occasionally
Travel from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
No
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Rarely
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Pay Range Minimum:$142,000.00
Pay Range Maximum:$236,000.00
Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.
