VP- Insurance Product Strategy, Design & Implementation

Company :Highmark Inc.Job Description : 

JOB SUMMARY

The VP of Insurance Product Strategy, Design, & Implementation will oversee product strategy, innovation, portfolio management and the development of necessary implementation roadmaps, and product performance evaluation, across Federal Markets, ACA/individual, DSNP, small group, large regional, and national accounts. With a scope that includes fully insured and ASO medical products across all geographies and customer segments, this team is responsible for the strategy, design and implementation of medical products that exceed $20 billion in annual allowed claims expense. Balancing profitability, enrollment and customer satisfaction commitments, the VP partners with segment Market Presidents, SVP/VP leaders of functional areas across Highmark Health/Highmark Inc./enGen to ensure that products meet the evolving needs of a highly regulated and competitive marketplace. With the addition of a broad array of Curated Health Solutions being designed in with the Living Health Solutions portfolio, the VP is responsible for the successful implementation of new, innovative products in addition to the large volume of standard product offerings.

The VP of Insurance Product Strategy, Design, & Implementation is also responsible for leading the overall strategy and alignment with senior leaders to create the multi-year vision, investment planning, and roadmap of process and technology solutions, and capabilities that are necessary to effectively deliver our medical products to customers and clinicians across Highmark Health. This leader will be responsible for standing up new capabilities, enhancing existing solutions and coordinating with other Product Management groups across the organization to develop and maintain an integrated, end-to-end product capabilities roadmap.

A successful incumbent will master cross-functional coordination and prioritization decision making, while ensuring that our complex product portfolio is developed, delivered, enhanced and transformed. Key skills and experience for the role include product strategy, product management, oversight of build and implementation; financial analysis/modeling; strategic planning and tradeoff decision making; deep customer insights; healthcare compliance and regulatory environment; and internal/external service delivery partner interactions.

ESSENTIAL RESPONSIBILITIES

• Integrated product strategy. Working across functions, develop a clear multi-year product strategy across existing segments (Federal Market, National Accounts, large regional, small group, ACA, and provider partnership products) and new geographies, that take into account and integrate all elements of product design (benefit design, networks, medical management, reimbursement design, ancillary benefits, customer service features, etc.). The product strategy is expected to be grounded in underlying market trends, the different needs of different market segments and feedback from customers and sales, and Highmark’s enterprise strategy. For each market segment, the strategy should clearly articulate Highmark’s differentiated value proposition and approach to driving greater customer value relative to local and national competitors and serve as the starting point for the development of a robust portfolio of products offerings. This includes product offerings that integrate Highmark’s medical, dental, vision, and stop loss capabilities, as well as the development of new integrated provider product designs that move towards greater risk-sharing and population health management.
• Drive product innovation. Actively monitor developments in the market and pilot, test, evaluate, and implement new product innovations. This could range from new benefit design structures to enhanced member communications around site of care recommendations to piloting new medical technologies relevant to specific market segment or customer needs, and will require an understanding of external market trends, innovations from other health plans, and new vendors and start-ups. Implementing this innovation will likely require managing any vendors participating in the delivery of products, programs or services.
• Product design and implementation oversight. Direct oversight of the team responsible for working collaboratively with various organizational stakeholders on the delivery of the product strategic roadmap through the development, maintenance, and implementation of a robust portfolio of products, which meet the needs of different market segments. Additionally working with actuary and the market leads to support pricing strategies.
• Product performance evaluation oversight. Oversee the team working with market leads, actuary, and finance, develop targets for product performance and assess performance against membership and financial targets. Understand and share what worked well and what didn’t work well based on actual market experience, identify opportunities for improving specific product performance, and incorporate findings into the multi-year product strategy.
• Product capability management. Based on the evolution of the product portfolio, developing a detailed multi-year roadmap of the support supporting capabilities the enterprise needs to deliver (e.g., benefits, network designs, medical management programs, new customer service capabilities, supporting marketing, etc.) our Living Health strategy. Ensures end-to-end product alignment for both the assigned product category suite, as well as full integration to business and IT strategies across the health care administration continuum and oversight of product lifecycle management to ensure value achievement.
• Other duties as assigned or requested.

QUALIFICATIONS

Required:

• Bachelor's Degree in Business Administration, Product Management/Design, Healthcare Management, Management Information Science, or related field
• 10 years of experience in healthcare strategy and execution/solution delivery
• 10 years of experience with deep breadth and depth of business knowledge across relevant functions (product, marketing, operations, etc.) in healthcare or similarly regulated product industry
• 7 years in a leadership role, with demonstrated ability to work in a matrixed organizational environment

Preferred

• Master’s Degree in Business Administration, Product Management/Design, Healthcare Management, Management Information Science, or related field
• Experience managing complex initiatives in the consulting, healthcare, or insurance industry
• Track record of driving transformational change, leading teams, developing talent, and building relationships
• Practice of Human Centered Design and/or Design Thinking process and methods
• Understanding of Agile Development techniques and tools

SKILLS

• Demonstrated strong comprehensive management, leadership and executive skills.
• Prior experience analyzing and applying a broad organizational and business perspective to identify and maintain focus on key drivers of organizational performance to maintain product viability and market share.
• Thorough knowledge of insurance, healthcare, insurance administration, marketing, strategic planning, financial management, reimbursement, and operations in health care markets.
• Strong understanding of market trends/needs, business requirements and balance them successfully. 
• Ability to directly and successfully lead, mentor and develop a talented team of high-performing individuals in a fast-paced environment. 
• External market orientation. 
• Demonstrated analytic and strategic problem solving skills

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office- or Remote-based

Teaches / trains others

Occasionally

Travel from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

No

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

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