Medicaid Product Specialist

Medica; Hopkins (MN); On-site; USD 51,000 - 87,000; Full time

Job summary

Medica, a nonprofit health plan serving Minnesota and beyond, seeks a Medicaid Product Specialist to collaborate with Product and other teams on developing and deploying D-SNP products. You will perform product analysis, participate in regulatory submissions, and support launches.

This office-based role requires a Bachelor's degree, 3+ years in managed care, and experience with Medicaid/Medicare. You will liaise with Operations, Clinical, IT, Marketing and Compliance to drive improvements and

Qualifications

• Bachelor's degree or equivalent experience in related field.
• 3+ years of work experience beyond degree.
• Experience working in Managed Care.

Responsibilities

• Support development, enhancement, and implementation of D-SNP products, benefits, and programs.
• Collaborate with Managers and stakeholders to assess product opportunities and implement strategic initiatives.
• Assist in annual product lifecycle activities, including benefit design, regulatory submissions, and operational readiness.
• Monitor product performance and recommend improvements to support objectives.
• Participate in new product launches, benefit changes, and program enhancements.
• Support analyses to evaluate product performance, member experience, utilization trends, and operational effectiveness.
• Research product, program, and operational challenges and provide recommendations for resolution.
• Analyze member, provider, and market data to identify trends, risks, and opportunities.
• Maintain knowledge of CMS, Medicare Advantage, Medicaid, and D-SNP regulatory requirements.
• Support implementation of regulatory changes impacting D-SNP products and programs.
• Collaborate with Compliance and Government Programs teams to ensure activities align with regulations.
• Assist with audits, readiness reviews, and regulatory reporting requests.
• Partner with stakeholders to ensure successful implementation and operation of product initiatives.
• Coordinate with Operations, Clinical, Network, IT, Marketing, and Vendor Management to resolve product issues.
• Contribute to process improvements and best practices.
• Support project planning, implementation, testing, and deployment for product initiatives.
• Assist with business requirements, user acceptance testing, and operational readiness.
• Track milestones, risks, dependencies, and deliverables.
• Ensure timely completion of deliverables and objectives.

Skills

3+ years experience

Managed Care

Organizational skills

Attention to detail

Time management

Interpersonal communication

Education

Bachelor's degree or equivalent experience

Tools

Microsoft Office

Job description

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for.

We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued.

The Medicaid Product Specialist collaborates with the Product team and other internal departments on the development and deployment of new and existing products. Completes product analysis, implementation activities, research product/program challenges and identify trends for improvements. Performs other duties assigned.

Key Accountabilities:

Product Development & Management

• Support the development, enhancement, and implementation of D-SNP products, benefits, and programs.
• Collaborate with Managers and business stakeholders to assess product opportunities and implement strategic initiatives.
• Assist in annual product lifecycle activities, including benefit design, regulatory submissions, and operational readiness activities.
• Monitor product performance and recommend improvements to support organizational and market objectives.
• Participate in new product launches, benefit changes, and program enhancements.

Analysis & Research

• Support analyses to evaluate product performance, member experience, utilization trends, and operational effectiveness.
• Research product, program, and operational challenges and provide recommendations for resolution.
• Analyze member, provider, and market data to identify emerging trends, risks, and opportunities.

Regulatory & Compliance Support

• Maintain working knowledge of CMS, Medicare Advantage, Medicaid, and D-SNP regulatory requirements.
• Support implementation of regulatory changes impacting D-SNP products and programs.
• Collaborate with Compliance and Government Programs teams to ensure product activities align with applicable regulations and contractual requirements.
• Assist with audits, readiness reviews, and regulatory reporting requests as needed.

Cross-functional Collaboration

• Partner with internal stakeholders to ensure successful implementation and operational execution of product initiatives.
• Coordinate with Operations, Clinical, Network, IT, Marketing, and Vendor Management teams to resolve product-related issues.
• Contribute to process improvements and best practices that enhance product management effectiveness.

Project & Implementation Support

• Support project planning, implementation, testing, and deployment activities for product initiatives.
• Assist with business requirement development, user acceptance testing, and operational readiness activities.
• Track project milestones, risks, dependencies, and deliverables.
• Ensure timely completion of assigned deliverables and project objectives.

Required Qualifications:

• Bachelor's degree or equivalent experience in related field
• 3+ years of work experience beyond degree
• Experience working in Managed Care

Preferred Qualifications:

• Experience working with Medicaid, Medicare, and / or Special Needs Plans
• Proficiency in Microsoft Office applications (Word, Outlook, Excel, PowerPoint, Teams)
• Strong organizational skills with the ability to manage competing priorities
• Attention to detail and accuracy to meet required quality measures and standards
• Demonstrated time management skills and ability to meet deadlines with quick turnaround timesAbility to work independently and apply strong problem-solving skills
• Strong interpersonal skills, along with excellent verbal and written communication skills

This position is an Office role, which requires an employee to work onsite at our Minnetonka, MN office, on average, 3 days per week.

The full salary grade for this position is $50,800 - $87,000. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $50,800 - $76,125. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.

The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.

Eligibility to work in the US:

Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States.

We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

This employer is required to notify all applicants of their rights pursuant to federal employment laws.

For further information, please review the Know Your Rights notice from the Department of Labor.