Vice President of ACA and Commercial Product Management

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Job Summary:

The Vice President, ACA and Commercial Product Management serves as the general manager of the ACA/QHP product line for WellSense Health Plan. This role is responsible for managing the product throughout the product life cycle from planning to execution in support of organizational priorities. This role is accountable for the strategy, performance, and health of the products that are assigned. Within the structure of the overall product portfolio and under the direction of the Chief Product and Sales Officer, they are part of a leadership group that also includes new product development and sales. They also lead other cross-organizational teams that execute on product priorities. To the broader WellSense Health Plan, their functional team is the overall subject matter experts on their product line and the value the product offers to stakeholders, the company and members.

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 analysis.
• 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 BMC, our partners, and providers to compete.
• Has P&L accountability for the ACA product line.
• Manages product line performance from a dashboard of KPIs that monitors the product's past, current, trending performance.
• Plans for the product line 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.
• Oversees and reviews win/loss analysis to determine why shoppers did not buy or members 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.
• Identifies dependencies of success on government rulemaking and procurement requirements, and works with Government Affairs and other subject matter experts to formulate and advance advocacy positions.
• 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 line 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 Medical Loss Ratio (MLR) through proper assessments and intervention efforts by working with Clinical.
• Working with Marketing and Sales utilizes up-to-date customer segmentation to understand and target prospects and members who are idea customers.
• Working with 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 line master book as a record 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 line is in good standing and compliant with regulator's directives.

  Supervision Exercised:

  • Directly manage 2-4 staff, indirectly manage the work of matrixed business partners

  Supervision Received:

  • General strategic guidance from the Chief Product and Sales Officer

Required Skills

Competencies, Skills, and Attributes:

• Leadership
• Strategy
• High performance mindset
• Emotionally intelligent
• Adaptive and flexible with ambiguity
• Strategic thinking and planning
• Solid Business judgement, decision making, and problem solving
• Systemic thinking
• Cross-functional influence
• Product Expertise
• Customer-centric thinking
• Mentoring and coaching skills

Required Experience

Education Required:

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

Education Preferred:

• Formal Product Management Certification or training preferred.

Experience Required:

• Experience successfully expanding and deepening an ACA product line
• 5 years successfully managing a product.
• 7 years' experience working with ACA products
• Experience successfully leading a functional team of product professionals
• Experience successfully leading and influencing cross functional teams.
• Experience developing territories, building and launching new ACA products.
• Strong relationship with the Connector in MASS and other state regulators in other states.

Experience Preferred/Desirable:

• 10 years of relevant experience as a leader in a health plan environment preferred.

Required Licensure, Certification or Conditions of Employment:

• Successful completion of pre-employment background check