The Health Connector's Policy and Plan Management team is seeking a Manager of Program and Product to provide day-to-day management of the Health Connector's Qualified Health Plan (QHP) and Qualified Dental Plan (QDP) product offerings. This role will engage in the full lifecycle of product development and implementation, including managing the annual procurement for health and dental plans via the Health Connector's Seal of Approval process. This position supports the integrity and success of plan management efforts required for the sale of individual and small group QHPs and QDPs through the Health Connector's web applications, serving as a key liaison between the Health Connector plan management, policy, and IT teams, as well as our technology, carrier and governmental agency partners. In this capacity, this role will play a key role in the Health Connector's offering of high-value health and dental products to more than 350,000 individuals and small business employees throughout Massachusetts.
The position reports to the Senior Director of Plan Management and Carrier Relations, with opportunities to engage with a variety of functional teams and leadership at both the Health Connector and various external stakeholders. (e.g., insurance carriers, technology and business vendors, various state and federal agencies).
General Responsibilities:
Successfully support execution of the annual Seal of Approval process, whereby QHP and QDP product design requirements are issued to potential insurance carriers seeking to sell products on the exchange, including the development of new strategic initiatives, updating procurement documents to reflect these initiatives, and communicating to bidders
Manage day-to-day plan management activities in conjunction with the Health Connector's IT team, including serving as a subject matter expert for IT system development, plan loading, as well as the requisite review, analysis and testing of data and systems, in collaboration with technology vendors and carriers
Proactively identify, evaluate, and recommend new or enhanced product improvements and benefit coverage designs, aligned with the Health Connector's mission and strategic priorities
Manage implementation of innovative carriers, programs and products as well as enhancements to existing programs and products; develop and execute against short and long-term project roadmaps
Actively monitor and stay current on key industry and market developments, trends, players
Manage provider network adequacy and geographic coverage area processes, as well as coordination with partner agencies, vendors, carriers and stakeholders
Own the collection and review of carriers' Seal of Approval submission materials, including the analysis and implementation of plan designs, rates, and provider networks used to populate plan information within the Health Connector's individual and small group shopping platforms
Support policy development and implementation for non-group (individual market) and small group products, including program eligibility, premium rating rules, provider network standards and regulatory guidance, with a focus on affordability and equity initiatives
Design and lead implementation of a robust provider network and access monitoring system to understand provider access dynamics based on membership geolocations, preferences, and feedback
Advise and recommend strategic directions and policy approaches to ensuring sound provider/network access across the Health Connector's lines of business
Develop subject matter expertise on various programs and systems, notably the System for Electronic Rate and Form Filings (SERFF) and serve as the Health Connector's internal expert on SERFF materials and processes used to transmit plan data into IT systems
Maintain and enhance critical working relationships with carrier contacts to: disseminate policy and technical guidance, collaborate on review/modifications of plan data submissions, and collect/raise internal awareness of relevant carrier feedback
Experience & Qualifications:
5-7 years of relevant experience in health or dental insurance product management, and/or project management; ideally working at or with health insurance carriers, healthcare providers, healthcare delivery systems, and/or healthcare focused government entities
Knowledge and interest in technology, public sector and health insurance markets; ideally, working knowledge of the ACA and health insurance marketplace technology and operations
Health and benefit plan design experience
Experience working with healthcare provider networks, e.g., contracting, network adequacy
Project Management certification, credentials, education and/or experience preferred but not required
Solid quantitative analytic skills, including advanced knowledge of MS Excel
Strong oral and written communication skills, including advanced knowledge of MS PowerPoint
Ability to work independently and as part of a team, focused on delivery of a variety of projects with tight timelines
Excellent attention to detail
Flexibility to adapt to changing environments and projects, and ability to learn quickly in a complex, technical environment
Strong MS Office Suite skills, including but not limited to Word, Excel and PowerPoint
If interested: Send a cover letter and résumé to Connector-jobs@mass.gov.
Salary: $100,000-105,000/year
Please note:
Due to the requirement of 268A, please complete the Applicant Disclosure Form and return it with your application. Link: https://www.mahealthconnector.org/wpcontent/uploads/ApplicantsDisclosureForm.pdf
All Health Connector employees are required to provide satisfactory proof of eligibility to work in the United States
The Health Connector is operating on a hybrid work arrangement with 2 days in the downtown Boston office and 3 days working from home.
Employee may be requested to work an extended day and weekends to meet deadlines
About the Health Connector:
The Commonwealth Health Insurance Connector Authority (Massachusetts Health Connector) is an independent public authority serving as the Affordable Care Act (ACA)-compliant marketplace for the Commonwealth. The organization is charged with providing subsidized and unsubsidized health insurance to individuals and small employers. The Health Connector also oversees policy development related to health care reform under both state and federal laws, as well as conducting public education and outreach about health care reform and coverage opportunities.
The Health Connector is an equal-opportunity employer that values diversity as a vital characteristic of its workforce. We consider qualified applicants without regard to race, color, religion, gender, sexual identity, gender identity, national origin, or disability.