Product Specialist Senior

Corewell Health • $80K — $95K *
Grand Rapids, MI 49504Hybrid
Healthcare
5 - 7 years of experience
Reposted 2 days ago
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Job Overview by Ladders

Qualifications

  • Bachelor's degree or equivalent in healthcare or business
  • 5+ years of experience in managed care
  • Strong understanding of the senior market and Medicare regulations
  • Familiarity with state and federal regulatory processes
  • Ability to interpret complex statutes and regulations

Responsibilities

  • Lead vendor onboarding and ongoing relationship management
  • Monitor adherence to performance expectations in contractual SLAs
  • Serve as primary contact for vendor issue resolution
  • Collaborate on vendor contracting, including scope and negotiations
  • Ensure contracts align with operational and regulatory requirements
  • Maintain oversight of compliance and performance provisions
  • Partner to evaluate vendor cost performance and ROI
  • Support financial monitoring and development of business cases
  • Identify cost optimization opportunities within vendor programs
  • Work closely to support benefit design and execution
  • Manage vendor-supported benefits during expansion initiatives
  • Participate in Medicare Advantage bid cycle activities
  • Assist in creating bid-related materials and reviews
  • Support regulatory reporting for vendor-delivered benefits
  • Develop and maintain member-facing communications and sales materials
  • Drive innovation initiatives to enhance member experience and outcomes

Benefits

  • Health, dental, and vision insurance
  • 401(k) plan with company match
  • Paid time off and holidays
  • Professional development opportunities
  • Flexible work arrangements
Full Job Description
Job Summary

This role is responsible for the end-to-end management of Medicare vendor relationships, including contracting, implementation, performance oversight, and optimization. The position partners cross-functionally to ensure vendor-delivered benefits meet regulatory requirements, achieve targeted financial outcomes, and support a high-quality member experience across multiple markets. Organize and maintain open lines of communication with internal and external customers to ensure that product information is up-to-date and accurate.

Essential Functions
  • Lead vendor onboarding, implementation, and ongoing relationship management in partnership with MA&R and internal stakeholders
  • Monitor and enforce contractual service level agreements (SLAs), ensuring vendors consistently meet performance expectations
  • Serve as the primary point of contact for vendor issue resolution, escalating and driving timely remediation
  • Collaborate with Procurement and implementation team on vendor contracting, including scope development, negotiations, and execution
  • Ensure contract terms align with operational, financial, and regulatory requirements
  • Maintain oversight of contract compliance and performance provisions
  • Partner with Actuarial, Advanced Analytics, and Clinical teams to evaluate vendor cost performance and return on investment
  • Support development of business cases, cost-benefit analyses, and ongoing financial monitoring
  • Identify opportunities to optimize value and cost efficiency across vendor programs
  • Work closely with internal teams including Medical, Analytics, Actuarial, Marketing, and Product to support benefit design and execution
  • Support implementation and ongoing management of vendor-supported benefits across future expansion states
  • Participate in Medicare Advantage bid cycle activities, including:
  • Reviewing Plan Benefit Packages (PBPs)
  • Supporting development of bid-related materials
  • Participating in cross-functional bid review meetings (monthly, quarterly, and annual cadence)
  • Support CMS regulatory reporting requirements related to vendor-delivered benefits
  • Partner with Marketing to develop and maintain:
  • Member-facing benefit communications
  • Sales materials and sell sheets
  • Website content updates
  • Ensure accuracy and compliance of all vendor-related benefit descriptions
  • Identify and evaluate new vendor solutions and emerging capabilities to enhance benefit offerings
  • Drive innovation initiatives to improve member experience, outcomes, and competitive positioning
  • Recommend enhancements based on performance data, market intelligence, and internal priorities


Qualifications

Required
  • Bachelor's Degree or equivalent in health care of business
  • 5 years of relevant experience in managed care
  • Solid understanding of the senior market and Medicare regulations
  • Familiarity with state and federal regulatory and legislative processes required; must be able to read and interpret complex statutes and regulations.


Primary Location
SITE - Priority Health - 1239 E Beltline Ave NE - Grand Rapids

Department Name
Product Administration Medicare - PH Managed Benefits

Employment Type
Full time

Shift
Day (United States of America)

Weekly Scheduled Hours
40

Hours of Work
8:00 a.m. to 5:00 p.m.

Days Worked
Monday to Friday

Weekend Frequency
N/A

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About Corewell Health

Corewell Health Careers

Joining Corewell Health presents an unparalleled opportunity to become part of a leading team of healthcare professionals dedicated to excellence. Corewell Health is renowned for its commitment to innovation, leadership, and providing superior healthcare services.

Explore Job Opportunities

Corewell Health is actively seeking talented individuals who are eager to contribute to a dynamic healthcare environment. The company offers a variety of job opportunities that cater to a range of skills and experiences. Whether you're a seasoned professional or a recent graduate, Corewell Health has a position that could be the perfect fit for your career ambitions.

Internship Programs

For those just starting their professional journey, Corewell Health provides robust internship programs designed to foster skills development and offer real-world experience in the healthcare industry. Internships at Corewell Health are a stepping stone to full-time employment and offer invaluable networking opportunities within the healthcare sector.

Growth and Development

Career growth is a cornerstone of employment at Corewell Health. The company supports its team members' professional development through comprehensive training programs, including leadership training and diversity training. These initiatives ensure that every team member has the tools and knowledge necessary to excel in their roles and advance within the company.

Benefits and Culture

Corewell Health is committed to creating a workplace culture that values diversity and inclusion. Employees enjoy a competitive package of benefits that supports both their professional and personal lives. The company's culture promotes teamwork and respect, making it an ideal environment for those who value collaboration and innovation.

Hiring Process

The hiring process at Corewell Health is designed to be transparent and efficient. Candidates are encouraged to submit a resume and may be invited for an interview to discuss their qualifications and career goals in more detail. Corewell Health values a thorough approach to ensure that all potential team members align with the company’s values and vision for the future.

Networking and Professional Development

Corewell Health believes in the power of networking and encourages its employees to engage with one another and the broader healthcare community. This engagement fosters a sense of community and collaboration, which is critical in the fast-paced world of healthcare.

Join the Team

Corewell Health is continuously looking for passionate, curious, and solution-driven individuals to join their ranks. Explore the open positions at Corewell Health by searching their Jobs and Careers page. Discover how your expertise and ambitions can contribute to the transformative work happening at Corewell Health.

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Learn more about Corewell Health
Industry
Hospitals & Medical Centers
* Ladders Estimates

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