Product Development Specialist

Company: Health Partners Plans, Inc.
Location: Philadelphia
Posted on: May 28, 2023

Job Description:

Medicare Advantage Product/Compliance Specialist Philadelphia, PA, USA Req #1496 Tuesday, April 18, 2023 Why Choose Health Partners Plans?We are an award-winning, not-for-profit health maintenance organization serving Pennsylvania residents.We offer Medicaid, Medicare, and Children's Health Insurance Program (CHIP) plans that include special benefits to improve the health and wellness of our members. We're also committed to boosting the health of our community through outreach, education, and events. Founded over 35 years ago, Health Partners Plans continually develops new ways to encourage better health outcomes and has received national recognition for our innovations in managed care.Perks of HPP and why you will love it here:

• Competitive Compensation Packages including 401(k) Savings Plan with Company Match and Profit Sharing
• Flextime and Work-at-Home Options
• Diversity & Inclusion commitment
• Impact on the communities we service We are hiring a Product Development Specialist to join our team remotely!
  The Product Development Specialist drives execution of new product development and new business opportunities from the end-to-end state of developing market strategy for the HMO, PPO and ACA products including leading the development of market assessments, competitive analysis, and business cases.
  As the Product Development Specialist, your daily duties may include---
  • Partner with corporate branding, marketing, and communications teams to develop and execute aligned products with strategic plans.
  • Work collaboratively with internal business teams to integrate new products and programs.
  • Oversee the development and presentation of marketing materials supporting various product (including member materials such as the Annual Notice of Coverage (ANOC), Explanation of Coverage (EOC), and Summary of Benefits (SB) and market recommendations for the product lines.
  • Review marketing and communication materials submitted by internal and external partners and stakeholders within the areas relating to our HMO, PPO, and ACA products.
  • Function as the subject matter expert for the CMS marketing/communication submission process and state filing processes from inception to completion.
  • Disseminate and manage Health Plan Management System ( HPMS) Product memos.
  • Initiate and manage internal and external corrective action plans (CAPs).
  • Provide timely filing of Medicare Part C and D reporting data to CMS.
  • Lead activities as articulated in the annual Compliance Workplan.
  • Provide interpretation of CMS Product rules and regulatory guidelines to all pertinent business and operational units that could impact our HMO, PPO, and ACA products.
  • Assist in the development, initiation, maintenance, and updating of policies and procedures.
  • Identify potential areas of vulnerability and risk to develop and oversee improvement plans for problematic issues.
  • Develop and submit as required monthly, quarterly, and annual reports related to regulatory agencies.
  • Work in conjunction with the corporate Compliance team and serve as a subject matter expert within the Company regarding the HMO, PPO, and ACA Product regulations.
  • This individual is responsible for communicating any required updates and approval statuses, ensuring all materials are compliant and adhere to state, federal and CMS prior to use. Qualifications and Skills, We Value
    • Required - Bachelor's degree in a business-related field or 7 years of equivalent experience required.
    • Required 3 years of CMS compliance related experience with the ability to understand all Medicare Marketing Product Guidelines and regulations.
    • Required clearly understand mandatory legal requirements, state filing regulations, and communicate required changes and statuses to internal business units and stakeholders.
    • Required 2-3 years of experience in project management concepts
    • Required- Superior interpersonal-skills, oral and written communication skills and analytical ability. HPP is a nationally recognized company for its innovations in care. We are more than your average health care company and can help you achieve your career goals!

Keywords: Health Partners Plans, Inc., Philadelphia , Product Development Specialist, Other , Philadelphia, Pennsylvania