Position Summary:Timely and accurate annual Medicare bid submission and dissemination of accurate product data across multiple teams and platforms is critical to the successful operations of our Medicare business. This key role on the Medicare Product team is responsible for our bid submissions, including dissemination of data and content to the Centers of Medicare and Medicaid Services (CMS) as well as internal business partners.
This role will provide subject matter expertise in areas including product management, product definition, risk identification, standard benefit models, and other areas of expertise based on professional knowledge and background with potentially significant financial and regulatory impacts. Many key business and compliance functions are dependent on this position and there is high visibility.
Primary Responsibilities:- Bid Submission, including:
- Interpret CMS guidance and requirements, including direct collaboration with CMS
- Support overall scope and strategy for bid submission, including defining standard benefit models and alignment to Product Strategy
- Deliver consumable, accurate plan and benefit information to internal and external stakeholders
- New or expanded capabilities for use by the bid team and business partners including plan structure management, formulary recon, expanded plan management, global benefit management, and additional quality controls
- Meet all CMS required deadlines and quality requirements
- Work collaboratively with Underwriting, Actuarial, and Pharmacy teams to define and drive requirements for plan/bid updates
- Product Content Management
- Accountable for delivery of content for CMS required materials (ANOC, EOC, SB)
- Cross Product content alignment between Group and Individual Medicare products
- Support business partner (Sales, Marketing, Digital, Communications) needs for non-required plan/benefit content
- Quality control across all downstream interactions:
- Execute quality controls across bid filing teams
- Lead and manage internal and external testing related to UHC and CMS digital properties
- Escalation and issue management
- Team Management
- Manage multiple teams and team members with varying levels of experience
- Create a pipeline of early careers talent to disseminate into the broader organization
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:- 5+ years of bid filing experience supporting multiple Product types across Medicare Advantage and standalone Part D such as Individual, Special Needs Plans, and Group
- 3+ years of experience in a Medicare managed care organization
- 3+ years of testing experience, ensuring quality and accuracy
- 2+ years of experience of directly working with the Centers for Medicare and Medicaid Services (CMS) and their infrastructure (HPMS)
- 2+ years of experience with automation including data-based rule writing
- Expert knowledge of the CMS defined Plan Benefit Package (PBP) and associated industry tools such as eMedicareSync
- Demonstrated ability to achieve high performance by utilizing resources in a matrix environment
- Demonstrated ability to work with and communicate with all levels of the organization
- Proven solid analytical skills
- Proven detail and accuracy orientation
Preferred Qualifications:- Experience with data management across multiple systems
- Experience working with Actuarial and Underwriting teams
- Familiarity with MAPS, eMS and MCARE tools used to manage Medicare Advantage and Prescription Drug bid filing data
- Demonstrated ability to work successfully in a changing environment
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $112,700 - $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.
