Resp & Qualifications

PURPOSE: 
Serves as a senior authority over Product Owners and product teams within CareFirsts Government Programs portfolio, including Medicare Advantage, Medicaid, and ACA offerings. This role is responsible for driving the prioritization and execution of complex claims-related initiatives, leveraging deep expertise in FACETS to ensure effective delivery and alignment with regulatory and business requirements.
Leads and manages complex product and project requirements, introducing innovative tools, frameworks, and best practices to enhance delivery outcomes. Oversees the development and enhancement of products supporting Government Programs, ensuring they meet the needs of both internal stakeholders and external members. Establishes and communicates clear business value for all initiatives, while providing strategic insights into opportunities, risks, and trade-offs to support informed decision-making and successful program execution.
making.

ESSENTIAL FUNCTIONS:

• Leads the development of two or more product portfolios and provides workable solutions to satisfy customer and market expectations in close collaboration with stakeholders, Product managers, product Owners, and scrum teams.
• Collaborates with senior leaders to identify and plan product releases by reviewing milestones with stakeholders; manages the continual development of existing products; coordinates and organizes workshops with product users using the discover and define approach; validates hypothesis and implements best solutions.
• Drives solutioning and long-term technical roadmap for complex products or products lines, ensuring they align with business goals and market demands.
• Communicates regularly with Products Managers and Product Owners to implement technical solutions; conducts product training to partners, staff, identifies need for individual/team training opportunities.
• Manages Product Blacklog(s) for the development teams by using product road mapping and backlog management tools; works closely with testing managers to ensure product functionality is properly tested against business requirements; leads change control processes to reflect project priorities.
• Aides in the development process by attending product refinement, sprint planning, and sprint reviews; contributes to wider initiatives and activities that support and increase customer satisfaction.
  
  

SUPERVISORY RESPONSIBILITY:
Leads a team utilizing a matrix management system.

QUALIFICATIONS:

Education Level: Bachelor's Degree in Product Management, Engineering, Information Technology or related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.

Experience: 10 years product owner experience with an in-depth knowledge of agile process and principles and/or product manager experience.

Licenses/Certifications Preferred Upon Hire:

• Certified Scrum Product Owner

Preferred Qualifications:

• Previous healthcare experience
• Medicare and Medicaid Products Experience
• TriZetto FACETS and Government Solutions Experience
• CMS and MCO Compliance Experience
• Claims Adjudication, Benefits Configuration, Provider and Payment Experience Preferred
• Advanced degree 
• Certified Agile Product Owner
• SAFe Agile Product Owner Certification

Knowledge, Skills and Abilities (KSAs)

• Proficient in project planning and life cycle development.
• Excellent communication skills both written and verbal.
• Proficient in Agile methodologies, principles, and procedures.
• Ability to use Product KPIs and business metrics to optimize the product.
• Ability to recognize, analyze, and solve a variety of problems.
• Ability to analyze, organize and prioritize work while meeting multiple deadlines.
• Able to define and articulate how proposed backlog items drive measurable outcomes, improve Star Ratings, or member retention.
• Skilled at gathering requirements from key stakeholders to build holistic user stories.
• Able to respond quickly to shifting regulatory environments or operational blockers, ensuring the team can deliver.
• Able to identify opportunities to enhance plan design or digital member experience based on competitive benchmarking and emerging models.
• Skilled at building alignment with stakeholders who have competing priorities.
• Skilled in advocating for user needs while balancing enterprise constraints.
• Strong ability to maintain trust with business needs, communicate tradeoffs clearly, and manage expectations.

Salary Range: $128,240 - $229,229

 

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.  It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Federal Disc/Physical Demand

Note:  The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

Physical Demands:

The associate is primarily seated while performing the duties of the position.  Occasional walking or standing is required.  The hands are regularly used to write, type, key and handle or feel small controls and objects.  The associate must frequently talk and hear.  Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship.

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