Insurance Product Manager 2 - Medicaid

Profile

Description

Responsibilities

The Insurance Product Manager 2 will:

Research each State's Medicaid rules, as it pertains to base benefits, expanded benefits, competitive analysis, etc. for intelligence gathering and strategy formulation

Responsible to maintain existing Medicaid markets on routine daily tasks and questions posted by the market and various regulatory agencies

Assist in meeting facilitation and documentation support

Review and file Medicare and Medicaid plans to ensure compliance with CMS guidance

Assist in the State Medicaid RFP (request for proposal) processes

Provide support of the creation and management of design and implementation deliverables.

Draft and/or audit member material and other internal documents, for both Medicare and Medicaid.

Gather and analyze data from multiple sources (such as State contracts and regulations) and transform in to useful information.

Assist in the review of upcoming and finalized State/Federal regulations, and coordinate team review for impact to the Medicaid area.

Collate and structure Medicaid Product data

Required Qualifications

Associate or Bachelor's Degree - related operations/compliance work experience may be considered

Previous experience with managed care

Comprehensive knowledge of all Microsoft Office applications, including Word, Excel, Access, PowerPoint, and Vision

May need to travel to Louisville, KY 1-2 times per year for required training/meetings

Experience with project management

Experience with researching and analyzing contracts

Detail oriented with excellent oral and written communication skills

Work at Home Guidance -To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested Satellite, cellular and microwave connection can be used only if approved by leadership. Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

COVID POLICY -Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.

Preferred Qualifications

Prior experience with operational and/or new plan implementation deliverables

Experience in regulatory guidance and contract interpretation

Previous experience with Medicaid

Committed drive to progress within the company

Scheduled Weekly Hours

40

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

Company info

Humana Inc.
Website : http://www.humana.com