Product Solutions Specialist II

Job Category: Sales & Marketing

Department: Commercial and Group Product Management

Location: Los Angeles, CA, US, 90017

Position Type: Full Time

Requisition ID: 11757

Salary Range: $77,265.00 (Min.) - $100,445.00 (Mid.) - $123,625.00 (Max.)

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan, serving more than 2 million members.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents.

The Product Solutions Specialist II is focused on providing end-to-end development and management for product line initiatives, applying technical healthcare contract expertise in the development and management of product line initiatives. This position supports contract-related inquiries, initiatives, and projects that support the overall product strategy and lifecycle, working closely with leadership and participating in cross-functional groups.

1. Responsible for identifying product management best practices.
2. Identify impacted parties, business partners, and resources required.
3. Collaborate and support in implementing best practices cross-functionally.
4. Recommend and participate in the design of processes and product requirements that support business needs.
5. Design methods for integrating functions and processes including applicable dependencies inclusive of enterprise initiatives.
6. Identify risks and help troubleshoot resolution of issues.
7. Participate in the Product Development Lifecycle and/or initiatives through the management of contracts and regulatory filings.
8. Collaborate with leadership to develop the regulatory filing schedule for cycle documents.
9. Prepare and ensure regulatory filing documents according to timeline.
10. Support all product contracts regarding benefits, quality performance measures, penalty risks, etc.
11. Monitor the tactics for compliance/contractual requirements.
12. Develop the technical product requirements according to contractual obligations to ensure compliance.
13. Facilitate the coordination of responses from partners for ad-hoc requests and develop responses according to established timelines.
14. Facilitate effective cross-functional meetings to adequately support new strategic implementations.
15. Primary contact for technical requirements, development, and execution.
16. Develop a sustainable and repeatable process for the technical adaptation and validation of product initiatives.
17. Evaluate and support the remediation efforts of member grievances or plan partners.
18. Perform other duties as assigned.

Bachelor's Degree. In lieu of degree, equivalent education and/or experience may be considered.

Required: At least 3 years of Commercial Medicare/Medi-Cal Product Experience (Product & Benefit knowledge) and of California Health Insurance Exchange (Covered CA)/Centers for Medicare and Medicaid Services (CMS)/Department of Health Care Services (DHCS) requirements experience.

Required:

1. Knowledge of product strategy.
2. Knowledge of product management and strategic planning and packaging concepts.
3. Ability to conclude and recommend using data and experience-driven decisions.
4. Ability to make decisions to drive towards and accomplish team objectives.
5. Strategic thinking skills and ability to create messaging to influence desired outcomes.
6. Ability to anticipate future demands of initiatives related to people, technology, budget, and business within your department and design/implement solutions to meet these needs.
7. Able to communicate results and business impacts to stakeholders within and outside of the company.
8. Ability to partner in the ingestion, consumption, and distribution of information from regulators with potential impacts on product.
9. Ability to effectively work closely with project team leaders and under the guidance of leadership.
10. Strong skills in MS suite - Word, PowerPoint, Visio, Project.
11. Strong knowledge of Department of Managed Health Care (DMHC), Covered CA, Centers for Medicare and Medicaid Services (CMS), and DHCS contractual requirements.

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Department Specifics:

Preferred: Experience in Health Care with Commercial products specifically in Qualified Health Plan (QHP) and/or Benefits related definition and requirements for LA Care Covered (LACC), L.A. Care Covered Direct (LACCD), PASAC lines of business.

Required: Experience serving Medi-Cal population. Skilled in building relationships with external partners. Service-oriented. Skilled in resolving conflict.

Preferred: Understanding of Medi-Cal managed care model, eligibility requirements, benefits, enrollment processes, and regulatory requirements governing Medi-Cal managed care plans. Understanding of managed care principles and operations.

Medi-Cal:

Required: Experience working in Medi-Cal managed care and serving the Medi-Cal population. Knowledge of Medi-Cal regulatory requirements and program guidelines.

Commercial Product:

Required: At least 3 years of Commercial regulatory filing experience (e.g. DMHC). Strong Adobe Analytics and other analytics tools skills.

Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.

L.A. Care offers a wide range of benefits including:

• Paid Time Off (PTO)
• Tuition Reimbursement
• Retirement Plans
• Medical, Dental and Vision
• Wellness Program

Nearest Major Market: Los Angeles

Job Segment: Medicare, Medicaid, Healthcare