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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in leading and developing teams within the Medicare Advantage product lifecycle, focusing on quality assurance, regulatory compliance, and operational metrics. Proficient in translating strategic priorities into actionable deliverables while ensuring adherence to deadlines and quality standards.
Highest-signal resume keywords
Medicare Advantage Product ExperienceTeam Leadership and DevelopmentRegulatory Compliance ManagementQuality Assurance and ValidationProcess Improvement Methodologies
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Healthcare Operations ManagementProduct Deliverable ManagementData Analysis and Performance MetricsResource Allocation and PrioritizationRoot-Cause AnalysisAudit ReadinessQuality Control StandardsWorkflow StandardizationImplementation PlanningPerformance Reporting
Soft Skills
Strong Communication SkillsProblem-Solving AbilitiesCoaching and MentoringAdaptability to Changing PrioritiesCollaboration Across Functional Teams
Tools & Technologies
HPMSPBPANOCEOCSBProvider DirectoryAprimo
Certifications & Qualifications
Bachelor's DegreeLean or Six Sigma Training
Industry Keywords
Medicare AdvantageRegulatory RequirementsOperational MetricsQuality AssuranceCompliance Standards
About the role
Key responsibilities & impact- Lead, coach and develop a team of Insurance Product Managers
- Translate portfolio and enterprise priorities into team objectives, work assignments and delivery expectations
- Prioritize and allocate resources across bid development, CMS filings, AEP readiness, implementation, validation and regulatory deliverables
- Monitor workloads and rebalance assignments as priorities, deadlines and portfolio needs change
- Provide coaching and actionable feedback to strengthen product knowledge, judgment and quality
- Lead a shared-service model providing product quality, validation, testing and delivery support across regional Medicare Advantage portfolios
- Establish workflows, service expectations and handoffs between the shared-services team and Senior Product Managers
- Coordinate capacity and priorities across multiple regional portfolio needs
- Translate product direction into downstream deliverables and implementation requirements
- Standardize approaches, tools and practices across portfolios
- Provide visibility into capacity, priorities, delivery status and risks
- Oversee validation, testing, filing support, implementation and readiness activities across the Medicare Advantage product lifecycle
- Establish quality standards for ANOCs, EOCs, SBs, Aprimo, Provider Directories, PBP, HPMS and other deliverables
- Ensure reviews and validations are completed accurately and on time, with issues tracked through resolution
- Monitor defects, rework and recurring quality issues and improve processes and controls
- Escalate significant product, compliance or delivery risks
- Maintain workflows and controls supporting Medicare Advantage regulatory and product requirements
- Drive audit readiness and ensure documentation, validations, controls and corrective actions are complete
- Track deliverables against CMS, regulatory and business milestones and develop mitigation plans
- Partner with Compliance and functional teams on findings and corrective actions
- Reinforce documentation, version control and evidence retention
- Use performance, quality and workflow data to improve accuracy, cycle time, capacity and productivity
- Lead process, tool and workflow improvements, including standardization or automation
- Conduct root-cause analysis and implement sustainable corrective actions
- Establish metrics and operating routines for workload, quality, risks and delivery performance
- Report to the Associate Director or Director, Insurance Product Management and collaborate with Senior Product Managers, regional portfolio teams, Compliance, Operations, Marketing and Claims
Requirements
What you’ll need- Bachelor's Degree or equivalent professional credential/licensure or experience (5+ years of relevant healthcare, health plan, product, operations or related experience)
- Demonstrated experience leading people, teams or complex work, including coaching, prioritization and accountability for results
- Experience managing regulated, operational or product deliverables with firm deadlines and quality requirements
- Demonstrated ability to prioritize work and allocate resources across competing deliverables
- Strong communication and problem-solving skills, with the ability to work effectively across functional teams
- Demonstrated ability to use data, quality measures or operational metrics to identify issues and improve performance
- Ability to lead through changing priorities and periods of high-volume, deadline-driven work
- Minimum home internet speed of 25 Mbps download and 10 Mbps upload
- Ability to work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
- Preferred: Medicare Advantage product, implementation or operational experience
- Preferred: Experience with the Medicare Advantage bid cycle, PBP and HPMS
- Preferred: Experience supporting ANOC, EOC, SB, Provider Directory or other Medicare Advantage product deliverables
- Preferred: Experience with product validation, testing, implementation or quality assurance
- Preferred: Audit, compliance or regulatory-readiness experience
- Preferred: Experience developing operational metrics, quality controls or performance reporting
- Preferred: Process improvement experience or training, including Lean or Six Sigma
- Preferred: Experience leading process standardization, automation or workflow improvements
Benefits
Comp & perks- Bonus incentive plan based on company and/or individual performance
- Medical benefits
- Dental benefits
- Vision benefits
- 401(k) retirement savings plan
- Paid time off
- Company holidays
- Personal holidays
- Paid parental leave
- Paid caregiver leave
- Short-term disability
- Long-term disability
- Life insurance
- Dedicated home workspace arrangement
- Remote work arrangement
- Occasional travel to Humana offices for training or meetings
