Product Manager II

The Product Manager II is responsible for development, implementation and ongoing management of a broad portfolio of Individual & Family products, across multiple states.

The Product Manager works with numerous Medica functional areas to determine the market need and feasibility for development of new products, enhancements to existing products, and all aspects of regulatory filings at both the state and federal level. The Manager is responsible for overall market success of the products, oversight of policy document development, timely and accurate CMS and state submissions (and meeting of requirements), and benefit structure. The Manager will set, maintain, document and preserve intent of product and plan design. The Manager works closely with segment leadership, sales, operations, compliance, legal, network, finance, pharmacy and actuarial, to continuously improve market competitiveness and market position as applicable, communicate and train staff on product details, and ensure proper administration and understanding of product intent.

The Manager is subject matter expert on assigned product lifecycle activities, plan performance, including membership, income, medical loss ratio (MLR) and operating margin, including for key accountable care organization (ACO) products, and will work directly with external ACO leadership on strategies to improve product performance.

Key Responsibilities:

• Leads product strategy and project teams to develop and deliver Individual & Family product solutions.
• Collaborates with segment leadership and functional leaders to address product-related issues and identify opportunities for improvement.
• Acts as a subject matter expert (SME) on benefits, including pharmacy coverage.
• Interprets federal and state regulatory guidance (such as ACA and CMS) and ensures compliance in benefit design.
• Researches and implements policies aligned with federal and state laws.
• Analyzes Individual & Family product areas to identify enhancements in benefits, networks, clinical aspects, and formularies.
• Collaborates with finance and actuarial teams to validate findings and recommend improvements.
• Understands Individual & Family products as well as background on the Affordable Care Act (ACA)
• Familiar with claims platforms, and processes.
• Leads product input for Individual & Family regulatory filings.
• Ensures benefit designs align with market trends, member needs, and financial goals.
• Independently prepares and maintains project documentation.
• Leads cross-functional teams to develop new programs, tools, and processes.
• Prioritizes recommendations related to measurement targets and consumer demand.
• Summarizes and analyzes results data for senior management.
• Manages competitive intelligence gathering for strategic decision-making.
• Organizes and analyzes data for internal and external stakeholders.
• Utilizes business acumen and analytical skills to identify effective solutions for Medica and vendors.
• Manages project costs, schedule, and scope using established processes and metrics.
• Ensures timely submission and response to contractual reporting requirements from state and federal government.
• Communicates project status and key metrics to all levels of management.
  
  
  

Minimum Qualifications:

• Bachelor's Degree in Healthcare, Business or related field or equivalent experience
• 5 Years in health insurance, with a minimum of 3 years directly with Individual & Family or Small Employer products

This position is a hub-based role which requires onsite presence. To be eligible for consideration, candidates must reside within a commuting distance to one of the following office locations: Minnetonka, MN or Madison, WI. Onsite frequency is determined by business need as decided by leadership and may be up to 2-3 days a week.

The full salary range for this position is $68,800-$118,000 Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.

The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.

We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.