Special Programs Manager I - Commercial Products

IEHP; Rancho Cucamonga (CA); On-site; USD 80,059 - 106,059; Full time

Benefits offered by this job

Competitive salary

On-site fitness center

Medical insurance with dental and vis

Life, short-term, and long-termdisabil

Career advancement opportunities

Wellness programs

Flexible Spending Account – HealthCare

CalPERS retirement

457(b) plan with match

Paid life insurance

Pet care insurance

Job summary

IEHP is seeking a Special Programs Manager I - Commercial Products to advance its commercial product initiatives within the Medicare & Commercial domain. The role drives development, implementation, and regulatory compliance for Individual products through the Covered California marketplace and coordinates with multiple internal and external stakeholders.

As a liaison among Compliance, Finance, Actuarial, Sales, Enrollment, Operations, Claims, Provider Network, Marketing, and Covered California,

Qualifications

• Three years of experience in health plan product management, health insurance operations, regulatory affairs, or related healthcare field.
• Experience with Covered California, ACA products, or Individual Marketplace products preferred.
• Experience coordinating cross-functional healthcare projects preferred.
• Experience with benefit design, enrollment operations, or healthcare analytics preferred.
• Project Management certification or equivalent experience preferred.
• Bachelor’s degree in relevant field required.
• Master’s degree preferred.

Responsibilities

• Support development, implementation, maintenance, and regulatory compliance of Individual products offered through the Covered California marketplace.
• Serve as liaison between internal departments and external stakeholders to ensure product filings and regulatory compliance.
• Collaborate with Compliance, Finance, Actuarial, Sales, Enrollment, Operations, Claims, Provider Network, Marketing, and Covered California representatives to support annual product renewals, regulatory changes, and strategic initiatives.
• Align product performance with IEHP’s Mission, Core Values and Strategic Priorities as defined by IEHP Executives and Leadership.

Skills

Project management

LEAN methodologies

Managed care knowledge

CMS/Covered California knowledge

Interpersonal skills

Communication

Microsoft Office

Education

Bachelor’s degree in Business Administration / Healthcare Administration / Public Health / Finance or related field

Master’s degree preferred

Tools

Microsoft Office

Microsoft Project

Job description

What you can expect!

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Under the direction of the Director of Product Implementation – Medicare & Commercial, the Special Programs Manager I - Commercial Products ensures advancement of IEHP’s commercial product initiatives. The Covered California Product Specialist is responsible for supporting the development, implementation, maintenance, and regulatory compliance of Individual products offered through the Covered California marketplace. This role serves as a liaison between internal departments and external stakeholders to ensure successful product filings, regulatory compliance, operational readiness, and ongoing product performance align with IEHP’s Mission, Core Values and Strategic Priorities as defined by IEHP Executives and Leadership. This role collaborates closely with Compliance, Finance, Actuarial, Sales, Enrollment, Operations, Claims, Provider Network, Marketing, and Covered California representatives to support annual product renewals, regulatory changes, and strategic initiatives. Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Perks

• Competitive salary
• State of the art fitness center on-site
• Medical Insurance with Dental and Vision
• Life, short-term, and long-term disability options
• Career advancement opportunities and professional development
• Wellness programs that promote a healthy work-life balance
• Flexible Spending Account – Health Care/Childcare
• CalPERS retirement
• 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance

Education & Requirements

• A minimum of three (3) years of experience in health plan product management, health insurance operations, regulatory affairs, or related healthcare field required
• Experience working with Covered California, ACA products, or Individual Marketplace products preferred
• Experience coordinating cross-functional healthcare projects preferred
• Experience with benefit design, enrollment operations, or healthcare analytics preferred
• Project Management certification or equivalent experience preferred
• Bachelor’s degree in business administration, Healthcare Administration, Public Health, Finance, or related field from an accredited institution required
• In lieu of the required degree, a minimum of four (4) years of additional relevant work experience is required for this position
• This experience is in addition to the minimum years listed in the Experience Requirements above
• Master’s degree from an accredited institution preferred

Key Qualifications

• Understanding of project lifecycle methodologies and LEAN methodologies
• Knowledge of managed care, healthcare, health plans, government products, and/or health plan accreditation principles and practices, enough to effectively lead projects within the organization
• Knowledge of health plan operations, including downstream impacts, to effectively implement initiatives
• Knowledge of CMS, DHCS, and Covered California requirements preferred
• Excellent interpersonal skills
• Excellent organizational skills
• Excellent communication skills: verbal and written
• Excellent organization, process, and project management skills
• Skilled in Microsoft Office programs including, but not limited to, Word, Excel, PowerPoint, Outlook, Access, and Project
• Ability to work in a complex, rapidly evolving environment which requires high-level initiative
• Ability to make quick adjustments to project deadlines or assignments
• Ability to work independently and collaboratively within a team environment
• Ability to effectively prioritize and manage multiple projects with competing deadlines
• Ability to apply knowledge and guide self
• Excellent attention to detail
• Proven ability to interact effectively at all levels of the organization
• Ability to work independently with little or no supervision and able to meet deadlines with little or no planning

Pay Range

• $80,059.20 USD Annually - $106,059.20 USD Annually