It’s an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.

Job Summary:

Reporting to the Vice President of Medicare Products and Duals, the Senior Director, Duals Product Management serves as the general manager for WellSense in all markets for all products that serve people eligible or enrolled in coordinated Medicare and Medicaid benefits including SCO, DSNP look-alike and Duals.. The Senior Director is responsible for managing the products throughout the product life cycle from planning to execution in support of organizational priorities.  The product director is accountable for the strategy, performance, and health of the products they are assigned.  Within the structure of the product portfolio and under the direction of the Product Line Leader (VP), they are part of a team that also includes new product development, product marketing, member/provider communications, sales and insights. They also lead cross-organizational teams that execute on product priorities, especially as they pertain to achieving business metrics, competitive advantage, financial results, and medical and administrative cost performance. To the broader WellSense Health Plan, they are the overall subject matter expert on their products and the value the product offers to stakeholder, members, the company, and members.    

Our Investment in You:

• Full-time remote work
• Competitive salaries
• Excellent benefits

Key Functions/Responsibilities:

Strategy

• Maintains a deep understanding of their market, prospective customers and current members.
• Understands the product’s role in the organization’s mission, vision, strategy and yearly goals.
• Defines the product’s strategy to fit within the overall portfolio’s purpose.
• Maintains a relevant product value proposition and positioning.
• Builds a multi-year product roadmap for growth.
• Submits a yearly product business plan and playbook.
• Conducts yearly PRESTO analysis, product retrospective, competitive position, and SWOT
• Watches for market opportunities from open spaces, disruptions, partnerships and innovations.
• Keeps a close eye on traditional, indirect, and potential competitors to plan, adjust and respond.
• Understands the buyer’s and member’s needs in order to maintain a fair value exchange and promote the member choosing, retaining, deepening and recommending the product.
• Aligns the product strategy with the corporate priorities and integrates with the plans in new product development, marketing, sales, operations, finance, clinical, etc.
• Prepares reports and presentations on their product’s strategy to more senior management and cross-functional teams.  
• Identifies, proposes, sponsor’s product growth initiatives necessary to achieve health plan growth goals, maintain the roadmap growth trajectory, and seize industry opportunities.
• Reviews to understand the political and regulatory environment in which the product lives. 
• Sets a strategy for working with Boston Medical Center Health System (BMCHS), our partners, and providers to compete.

Performance

• Manages and owns the P&L of the product.   
• Manages product performance from a dashboard of KPIs that monitors the product’s past, current, trending performance.  
• Plans for the product profitability working closely with actuarial to understand the pricing levers and options before approval of the pricing strategy.
• Reviews and understands product financials in order to drive product changes and inform business decisions.
• Conducts and reviews win/loss analysis to determine why shoppers did not buy or member’s remain to what steps they took in the buying process. 
• Determine customer needs and determine effectiveness from an outside-in view by working with insights leaders and external sources.
• Attracts profitable members through segmentation, targeting, consumer marketing and sales by working with marketing and sales leaders. 
• Works with performance data around market, usage, sales, service and operations to determine if product objectives are being reached.

Health

• Makes key business decisions for the product resulting in maintaining a healthy condition.
• Provides subject matter expertise on the product to the company on its creation, composition, design, features, relevance, use, and role in the portfolio.
• Develops product impact views on policy positions and advocates for conditions that are favorable for the long term viability of the product by working with public partnerships, government affairs, legal and the regulator.
• Identifies gaps in operational state due to missing or inadequate capabilities, partnerships, internal staffing or processes by working with operations.
• Assesses the adequacy of the processes and platforms on which the product operates by working with technology and operational leaders
• Works with benefits administration to implement the benefits design that is best for target customers, marketplace competitiveness and the products P&L.
• Works with finance to forecast, set annual product budget, and determine spending vs. realized benefits.
• Works with clinical and pharmacy to assure that our approach is healthy for both the client and KPI for the product
• Manages and prioritizes the design of the product with internal business areas and external consultants to match market and customer requirements.
• Maintains a healthy MLR through proper assessments and intervention efforts by working with Clinical.
• Working with BMCHS Population Health, Marketing and Sales utilizes up-to-date customer segmentation to understand and target prospects and members who are idea customers.
• Working with BMCHS Population Health, Marketing and Operations, understands the prospect and customer’s journey to assure that the value provided and experience with the product is satisfactory or better in order to maintain the right levels of sale and retention.
• Keeps a product master book as record of for the organization.
• Working with Provider Networking to assure that the network and current contracted relationships are adequate for the product’s health and growth. 
• Determines the product investments needed to keep the product healthy.
• Understands and assures that the product is in good standing and compliant with regulator’s directives. 

Supervision Exercised:

• May directly supervise staff

Supervision Received: 

• Operates under general supervision of Vice President of Medicare Products

Qualifications: 

Education Required: 

• A Bachelor’s Degree in a related field such as business or marketing. 

Experience Required: 

• Experience successfully expanding and deepening a Duals product. 
• 3 years successfully managing a product.
• 5 years experience working with a duals and specialty product
• Relevant experience in a health plan environment preferred
• Relevant experience working with senior products or senior customers preferred
• Experience successfully leading and influencing cross functional teams.
• Experience working under State and CMS requirements; MassHealth preferred.
• Experience influencing medical centers, providers, CHCs and physician partners.

Required Licensure, Certification or Conditions of Employment: 

• Formal Product Management Certification or training preferred.
• Successful completion of pre-employment background check

Competencies, Skills, and Attributes: 

1. Entrepreneurial spirit
2. High performance mindset
3. Takes initiative and decisive action
4. Emotionally intelligent
5. Adaptive and flexible with ambiguity
6. Strategic thinking and planning
7. Solid Business judgement, decision making, and problem solving
8. Systemic thinking
9. Cross functional influence
10. Product Expertise
11. Customer centricity
12. Attentive listening and active observing

Working Conditions and Physical Effort: 

•         Remote work with occasional on-sight collaboration efforts.
•         May require occasional travel.
•        No or very limited physical effort required. No or very limited exposure to physical     
         risk. 

About WellSense

WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees

About WellSense Health Plan

WellSense Health Plan is a non-profit managed care organizations committed to providing the highest quality healthcare coverage to underserved populations. We are focused in Massachusetts and New Hampshire.

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