Product Manager, Med-D

This is a fully remote position, open to applicants in Alabama, +34 more locations.

📋 Description

• Oversee product management for the Navitus Medicare Part D program.

• Spearhead the design, development, implementation, and management of Medicare Part D processes in alignment with regulatory requirements and client needs.

• Review and respond to CMS technical and business process/operational guidance.

• Ensure the implementation of suitable software, procedures, and oversight monitoring.

• Cultivate and sustain subject matter expertise concerning Medicare Part D rules and regulations.

• Monitor and analyze CMS regulations, guidance, and system modifications.

• Manage the development, implementation, and ongoing maintenance of Medicare Part D processes for all clients in the program.

• Create project plans and lead initiatives aimed at enhancing the Medicare Part D program.

• Apply project management tools and principles to implement requirements.

• Establish reliable processes and effective monitoring systems.

• Conduct operational oversight for services delegated by Medicare Part D clients and ensure alignment with identified risks.

• Identify and implement process enhancements to boost efficiency, automation, scalability, and compliance/risk management.

• Execute corrective actions to address compliance issues, ensuring root-cause analysis and ongoing monitoring.

• Assist with CMS audits and client oversight audits.

• Provide subject matter expert support to the organization and Medicare Part D clients.

• Support Sales efforts by contributing to Medicare Part D-specific RFP responses as necessary.

• Ensure that policies and procedures comply with Part D and regulatory requirements.

• Conduct oversight to confirm that guidance citations are accurate and up-to-date.

• Perform periodic audits of functional-area performance.

• Undertake other duties as assigned.

⛳️ Requirements

• Bachelor’s degree or equivalent work experience in Medicare Part D is required.

• A minimum of 3 years of experience in Medicare Part D is required.

• Preferred expertise in Medicare Part D regulations with demonstrated accountability in areas such as coverage determinations, appeals and grievances, prior authorizations, formulary management, and transition monitoring.

• Experience in government program compliance oversight and familiarity with CMS audit protocols is highly desirable.

• Actively participate in and support compliance program objectives.

• The ability to engage cooperatively and respectfully with other employees consistently.

🏝️ Benefits

• Exceptional benefits for Health, Dental, and Vision insurance.

• 20 days of paid time off.

• 4 weeks of paid parental leave.

• 9 paid holidays.

• 401K company match of up to 5% with no vesting requirement.

• Adoption Assistance Program.

• Flexible Spending Account.

• Educational Assistance Plan and Professional Membership assistance.

• Referral Bonus Program – up to $750!