Medicare Product Development Lead

This role operates as a strategic resource across the Medicare Advantage (MA) function, bringing analytical depth, competitive intelligence, and cross-functional coordination to advance enterprise Medicare product objectives. The Lead Consultant independently conducts market and performance analysis, develops strategic recommendations, and coordinates across functional partners to ensure cohesive, insight-driven execution.

Responsibilities

• Lead benefit design decisions across core and supplemental benefit categories, balancing member value, competitive positioning, and margin targets.
• Review competitive intelligence, translate population health insights and utilization data into benefit configurations that differentiate the MA EGWP offering.
• Partner with actuarial to review benefit cost assumptions against enrollment and risk score scenarios.
• Drive strategic framing of pricing decisions and financial modeling to support product decisions.
• Ownership of product roadmap towards CMS bid cycles, other regulatory contract requirements, and internal governance timelines.
• Support synthesis of regulatory guidance, sub-regulatory memos, and policy developments, recommending strategic implications and product strategy adjustments for team consideration.
• Support go-to-market strategy and Plan engagement coordination across the MA function.
• Develop strategic materials and analytical frameworks to support compliant member-facing and broker-facing program execution in partnership with Sales and Field Services.
• Coordinate with Plan partners on engagement activities, distribution strategy, and training support.
• Monitor go-to-market performance indicators and recommend strategic adjustments to improve market penetration, member acquisition, and retention outcomes.
• Support broader MA program strategy including Part D formulary strategy, network strategy, and Stars/Quality strategy with cross-functional partners.
• Serve as a connective resource across the MA organization, coordinating with functional leaders, Plan partners, and enterprise stakeholders to advance cross-cutting priorities.
• Represent the Medicare product function in working groups, advisory forums, and stakeholder discussions, bringing analytical perspectives and strategic context.
• Build and maintain effective relationships across the broader BCBSA Medicare ecosystem to support integrated, enterprise-aligned program execution.

Requirements

• BS in Healthcare, Business Administration, Public Health, or related field; or equivalent experience.
• 7+ years of experience in healthcare product development, Medicare product management, or health plan operations, with a track record of independent execution and cross-functional coordination.

Skills

• Proficient knowledge of Medicare Advantage and Part D benefit design, CMS regulatory requirements, and the annual bid cycle process (HPMS submissions, benefit package configuration, regulatory review).
• Demonstrated ability to independently execute complex work streams, coordinate across multiple functions, and manage concurrent deliverables in a regulated environment.
• Strong analytical skills with ability to interpret utilization data, competitive benchmarking, and quality/Stars metrics to drive benefit enhancement decisions.
• Strong written, oral communication, and presentation skills; ability to develop clear analytical materials and represent workstream findings to senior stakeholders.
• Proficiency in Microsoft Office (Word, Excel, PowerPoint); familiarity with project management tools and data visualization platforms.
• Effective stakeholder coordination and relationship-building skills with the ability to collaborate across Legal, Compliance, Actuarial, Clinical, and Operations functions.
• Understanding of FEHBP program structure and applicable regulatory requirements as they relate to MA EGWP product design and administration preferred.

Pay

The posted salary range for this position is $129,959.06 - $175,749.89. This job is also eligible for annual bonus incentive pay.

Benefits

• Paid time off and 11 holidays.
• Medical, dental, and vision insurance.
• Generous 401(k) matching.
• Lifestyle spending account.
• Many other benefits to eligible employees.