Fallon Health

Product Manager lll

Fallon Health$110K — $120K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's Degree required.
  • 5-10 years experience in healthcare setting.
  • 5+ years as Product/Project Manager.
  • Managed care experience essential, including operations and compliance.
  • Knowledge of Medicare and Subsidized Connector Commercial products is important.

Responsibilities

  • Lead cross-functional teams for successful product implementation.
  • Collaborate on annual rate filing submissions with product and actuarial teams.
  • Serve as subject matter expert for product filings and regulatory submissions.
  • Act as liaison across departments, regulatory bodies, and third-party vendors.
  • Develop and maintain product collateral in partnership with communications.
  • Deliver product training to internal and external stakeholders.
  • Oversee product portfolio performance metrics and reporting.

Benefits

  • Opportunities for professional development and training.
  • Collaborative working environment with cross-functional teams.
  • Involvement in strategic, high-profile projects.
  • Direct influence on product development and consumer experience.
  • Focus on regulatory compliance and industry standards.
Full Job Description
Overview

Brief summary of purpose:

Under the direction of the Director of Product Management, the Product Manager III works independently and collaboratively with both internal customers and external stakeholders. The Product Manager III will take high profile and strategic projects from development through implementation. responsible for managing the product portfolio for a specific market segment. This includes developing new product features, enhancements, portfolio revisions and overall product lifecycle management. The position requires a high level of operational as well as strategic focus. The Product Manager III will make recommendations to the Director of Product Management and Product Owner on product changes that will improve competitive positioning, mitigate cost for the member or Fallon Health, streamline or increase integrity of internal processes and that ultimately enhances the overall consumer experience

Responsibilities

Primary Job Responsibilities:
  • Demonstrated ability to lead cross-functional teams, facilitate decision-making, and maintain end-to-end accountability for successful product implementations and enhancements.
  • Collaborate with product ownership and the Actuarial team on the development and submission of annual rate filings.
  • Strong knowledge of federal and state regulatory requirements, with direct experience engaging with the Massachusetts Health Connector
  • Comprehensive understanding of Fallon Health systems, including key interdependencies and the dependencies between products, internal platforms, and external vendor partners
  • Act as the primary subject matter expert and responsible leader for product filings, including product oversight of Evidence of Coverage (EOC), SERFF plan and benefit templates, HIOS submissions, and connector seal of approval submission
  • Serve as Fallon Health's lead or key contributor for new product development and implementation initiatives, and partner with product ownership to support the design and execution of customized product solutions
  • Function as a central liaison across Fallon Health departments, external regulatory bodies, and third-party vendors to address product-related inquiries and resolve issues
  • Partner with Corporate Communications and regulatory to develop and maintain product collateral; ensure all materials-member, and provider-facing-accurately reflect product design, operational processes, and applicable policies, and benefits.
  • Develop and deliver internal and external product training to ensure alignment and understanding across stakeholders
  • Oversee and report on product portfolio performance, including financial results, membership growth and retention, operational effectiveness, clinical utilization, and overall customer experience


Qualifications

Education:

Bachelor's Degree

License/Certifications

Experience:

5 - 10 years in a healthcare setting and 5+ years as Product/Project Manager. Managed care experience with knowledge of plan operations, IT, finance, actuarial, compliance, product implementation, corporate communications, customer service, provider network management, federal and state health insurance regulations, marketing, product management. government agencies including the Massachusetts Health Connector. Considerable knowledge of Medicare and Subsidized Connector Commercial products is important. Experience with M/S Office, PowerPoint, Excel, SharePoint, and One Drive preferred.

Resources:

Outlook, Microsoft Office Suite, Microsoft PowerPoint, Visio, Sharepoint

Pay Range Disclosure:
In accordance with the Massachusetts Wage Transparency Act, the pay for this position is $ 110,000-$120,000 annually which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate's experience, skills, and fit with the role's responsibilities

About Fallon Health

Fallon Health is a non-profit health care services organization that provides health care services designed to meet the unique and changing needs of all we serve. We are committed to providing our members with the highest quality health care products and services, while also providing our employees with a supportive and rewarding work environment. Our mission is to improve the health and well-being of our communities by providing innovative, high-quality, and affordable health care services.
Learn more about Fallon Health
Size
1,200 employees
Industry
Founded
1977

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