Product Manager - Commercial Operations (Hybrid)

CareFirst • Baltimore, MD • 1d ago

Resp & Qualifications

PURPOSE:

Seeking an experienced and highly motivated Product Manager Commercial Operations to lead Product Lifecycle implementation and regulatory filing support, including execution of required state and federal submissions such as annual Qualified Health Plan (QHP) filings. The ideal candidate will have experience working with a single source of truth benefits system that drives plan design to downstream systems, including the contractual Schedule of Benefits (SOB), Summary of Benefits and Coverage (SBC), and Broker Benefit Summaries.

This role requires deep knowledge of health plan benefit structures, with the ability to analyze benefits in a streamlined, automated manner and translate complex business and regulatory requirements into actionable product specifications and operational deliverables.

This position works cross-functionally with Product Strategy, Actuarial, Compliance, Legal, Underwriting, Configuration, Mandates, and IT to support successful annual filings, product implementation, and ongoing product enhancements. Additional responsibilities include conducting benefit audits, validation testing, and operational reviews to identify discrepancies and compliance gaps.

ESSENTIAL FUNCTIONS:

Lead regulatory filing execution by interpreting filing requirements, establishing processes and documentation, and guiding team members to complete product implementation and regulatory filing activities. Collaborate closely with business leaders to communicate status, escalate risks, and develop plans to achieve business goals.

Develop and maintain commercial market portfolios within the single source of truth system to support accurate, automated benefit grids, SBCs, SOBs, and Plan and Benefit Templates (PBTs).

Analyze benefit and regulatory data and provide strategic recommendations to streamline processes across market segments and jurisdictions, reduce inconsistencies, and improve accuracy. Translate Product Strategy into detailed benefit design specifications to ensure accurate implementation across downstream systems.

SUPERVISORY RESPONSIBILITY:

Position does not have direct reports but is expected to assist in guiding and mentoring less experienced staff. May lead a team of matrixed resources.

QUALIFICATIONS:

Education Level: Bachelor's Degree in Marketing, Business or related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required.

Experience: 3 years product analysis, product management or related business experience.

Knowledge, Skills and Abilities (KSAs)

Highly developed analytical skills and must be able to effectively communicate complex marketing and business-related issues to a diverse audience (both written and orally).

Ability to build productive relationships, be effective in individual and group meetings, be skilled in conflict resolution negotiations, and be able to lead and work effectively on cross-functional teams.

Aggressive in desire to produce innovative alternatives and be willing to defend suggestions in varied circumstances.

Proficient in Word, Excel, and PowerPoint.

Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

Salary Range: $71,280 - $141,570

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Federal Disc/Physical Demand

Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, @type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

LI-LJ1

REQNUMBER: 22171

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