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MedImpact Healthcare Systems

Principal, Adjudication Product Management

Posted 2 Days Ago
Be an Early Applicant
Remote
Hiring Remotely in USA
115K-206K Annually
Senior level
Remote
Hiring Remotely in USA
115K-206K Annually
Senior level
Lead the strategy and execution of adjudication products, manage product lifecycle, and collaborate with stakeholders to optimize healthcare solutions.
The summary above was generated by AI

Exemption Status:United States of America (Exempt)

$114,622 - $160,472 - $206,321

“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors.  A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”

This position is not eligible for Sponsorship.

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description

Summary

The Principal, Adjudication Product Management leads the overall strategy, goals, and objectives for MedImpact’s Laker Adjudication Platform. This position will be the product lead and will drive initiatives with the Laker product management team and IT.  Creating, maintaining, and executing on the product(s) strategic vision and roadmap by serving as a trusted partner to business and technical owners, including but not limited to, Operations, Clinical, Account/Client Management, IT, and Customer Service.

The position’s focus will be to lead the creation and support of key adjudication products from inception to execution and document and prioritize critical product features that impact bottom line performance. Working across the organization the Principal, Adjudication Product Management focuses on delivering products that provide meaningful value to users and customers of our PBM and Software as a Service (SaaS) offerings. Works with a range of internal partners and external partners, gathering their perspectives throughout product roadmap creation and evolution.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

  • This position is responsible for leading the strategy and execution of product enhancements and end-of-life planning for existing claims and adjudication products and services from concept through deployment. Ensures products and services are successful, meet corporate operational excellence criteria and support revenue goals.
  • Leads the research, development, and implementation of adjudication products and services. Identifies, analyzes, monitors, and suggests actions for products and services that materially contribute to overall mission and strategy of the company.
  • Evaluates new product development opportunities and existing product enhancements based on regulatory and/or client need.  Leads product feature prioritization with business and technical stakeholders to ensure product features are prioritized appropriately.
  • Develop business cases from internal and external clients for new product builds or enhancements of existing products. Collaborate with IT stakeholders to obtain high level and detailed budget estimates to support business cases and system development.
  • Leads the conceptualization, design, product development and implementation of approved new and expanded products & services utilizing industry standard methodologies for product lifecycle management. Working with business owners, IT stakeholders, and Product Readiness to ensure proper product documentation and testing of systems before solutions are moved to the production environment, including that required for product release, training, and postproduction support.
  • Responsible for the execution of simultaneous products under development, from product concept and approval through deployment. This will include ownership or support of product strategy definition and roadmap; development of marketing and product requirements documents with prioritized features and corresponding justification in partnership with business owners and technical stakeholders; prototype development; and development of strong voice of the customer and competitive intelligence. This position will interface with other areas within the company, including but not limited to IT, Sales & Marketing, Operations, Finance/Analytics and Project Management.
  • Provides product management oversight for assigned products and services, including annual strategic product planning; revenue and expense budgeting and forecasting; pricing; support of product and sales material development; product training, assessment, and support; RFP support; and product demonstrations.
  • Serves as the primary subject matter expert for cross functional business units for claims and adjudication product development and management.
  • Conducts market and regulatory analysis by retrieving information from a variety of sources, including but not limited to proprietary databases, Internet, focus groups and other data sources.  Utilizes information retrieved to conduct research and analysis and presents results to leadership and product teams.
  • Completes all documentation throughout the product or project lifecycle, including creating business cases, business plans, business requirements, and product roadmaps.

Supervisory Responsibilities        

May Manage assigned staff in the segment area. Responsible for the overall direction, coordination, and evaluation of the unit. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. Supports and enforces all company policies and procedures in a fair and consistent manner, taking corrective action whenever necessary.

                                   

Client Responsibilities

This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written).  One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience

BA/BS Degree; 8+ years related experience and 8+ years of SME in respective area(s); (or equivalent combination of education and experience) with at least 4+ years leading individual contributors and leaders of leaders; which may be substituted with an appropriate mix of leadership experience and 5 years of MedImpact experience plus an appropriate external leadership training program and internal mentorship with a seasoned leader (VP+ level) that must completed within 12 months in new position.

Computer Skills

To perform this job successfully, an individual should have knowledge of Microsoft Office Suite, Microsoft Project and a working knowledge of systems platforms and new technologies.

Certificates, Licenses, Registrations

Product Management Certification (e.g. AIPMM, PDMA, Pragmatic Institute) preferred.

Project Management Professional and Certified Scrum Master certification preferred.

NCT-NCPDP Telecommunication Standard certification required

Other Skills and Abilities

  • Previous new product development and product management experience required, preferably in health information technology or a closely related field.
  • Prior pharmacy benefits management, disease management, healthcare, or managed care environment experience.
  • Experience in more than one of the following disciplines a plus: Technology Management, Medicare Compliance, or Operations. 
  • Subject matter expertise in claims and adjudication product and project lifecycle management and methodologies, continuous quality improvement, and change management.
  • Knowledgeable in marketing, including market research, market sizing, targeting, pricing, marketing communications, sales training, and product launch.
  • Thorough knowledge of IT systems, applications, databases, architecture, and software development lifecycle, computer engineering including experience working with modern software development methodologies and enterprise systems architectures.
  • Active membership in National Council for Prescription Drug Programs (NCPDP) with participation in relevant standards development Work Groups and Task Groups
  • General knowledge of finance, including ability to read and understand financial data such as product income statements, ROI analysis, net-present value analysis.
  • General knowledge of operations, including scheduling, test engineering and quality systems preferred.
  • Knowledge and experience with Agile product and project management methodologies a must.
  • Clear track record for achieving goals and deliverables that meet revenue goals.

Reasoning Ability

  •  Ability to define problems, collect data, establish facts, and draw valid conclusions.
  • Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.

Mathematical Skills

  • Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume.  Ability to apply concepts of basic algebra and geometry.
  • Ability to apply mathematical operations to such tasks as frequency distribution, determination of test reliability and validity, analysis of variance, correlation techniques, sampling theory, and factor analysis.

Language Skills

  • Ability to write routine reports and correspondence.  Ability to speak effectively before groups of customers or employees of organization.
  • Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community.

Competencies To perform the job successfully, an individual should demonstrate the following competencies:

  • Business Acumen
  • Directing Others
  • Organizational Agility
  • Conflict Management
  • Drive for Results
  • Political Savvy
  • Customer Focus
  • Innovation Management
  • Strategic Agility
  • Decision Quality
  • Managerial Courage

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

This position may regularly be exposed to or encounter moving mechanical parts, high, precarious places, fumes or airborne particles, toxic or caustic chemicals, outdoor weather conditions, risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples: business office with computers and printers, light traffic).

Work Location

This position works on-site at the San Diego Headquarters or other company location (or from a remote location with management approval based on business requirements). Must provide adequate support to internal clients; be available for regular interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as be available to facilitate effective decisions through collaboration with stakeholders.

Working Hours

This is an exempt level position requiring the incumbent to work the hours required to fully accomplish job responsibilities and reasonably meet deadlines for work deliverables. The individual must have the flexibility to work beyond traditional hours and be able to work nights, at weekends or on holidays as required.  Work hours may be changed from time to time to meet the needs of the business.  Typical core business hours are Monday through Friday from 8:00am to 5:00pm.

Travel

This position may require domestic travel.

The Perks:
  • Medical / Dental / Vision / Wellness Programs
  • Paid Time Off / Company Paid Holidays
  • Incentive Compensation
  • 401K with Company match
  • Life and Disability Insurance
  • Tuition Reimbursement
  • Employee Referral Bonus

To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers

MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego,
California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.

Equal Opportunity Employer, Male/Female/Disabilities/VeteransOSHA/ADA:

To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Disclaimer:

The above
statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.

Top Skills

Microsoft Office Suite
Microsoft Project

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