MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
Position Overview The Product Specialist is a critical role in support of the efficient functioning of the product team. The Product Specialist will perform complex and diverse duties, assist in problem solving, program/project planning, development, and execution of stated goals and objectives.
Job Description- Work with Product Managers on product and benefit implementations aligning the organizational strategy of Products.
- Participate in key strategic and operational meetings both internally and externally.
- Be well-versed in, or willing to learn, federal and state regulations and policies relevant to the health insurance industry.
- Assist in Benefit grids ensuring updates are made accurately and timely.
- Understand multiple product line processes working to streamline processes across all products.
- Work as project manager within product team ensuring projects are on track and timely.
- Assist in the coordination, supervision, and completion of special projects as appropriate.
- Assist multiple members of the team in developing policies & procedures, workflows, and KPI dashboards/reports, preparing materials for presentations, maintaining workplans & meeting agendas.
- Knowledge of NYS Health Exchange business
- Assists in reviewing and updating of Exchange Model Contracts and member materials.
- Manages and maintains member facing material with Printing Vendor.
- Collaborates with various departments to ensure benefits are configured accurately.
- Helps research applicable member complaints.
- All other tasks as assigned or needed.
Minimum Qualifications- Bachelor's degree required with four years of prior experience in a Managed Care setting.
- Demonstrated ability to develop workflows, policies, procedures.
- Demonstrated ability to identify opportunities for improvement & implement solutions.
- Excellent analytical skills demonstrated by an ability to use actionable data to support decision-making.
Professional Competencies
- Results-driven
- Systems orientation
- Process improvement.
- Data-driven
- Customer focus
- Excellent written & verbal communication skills
- Resourcefulness
- Ability to work effectively in a fast-paced & constantly evolving field
- Demonstrate understanding & acceptance of the MetroPlus Mission, Vision, & Values
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