Summary

The Principal Adjudication Product Management leads the overall strategy goals and objectives for MedImpacts Laker Adjudication Platform. This position will be the product lead and will drive initiatives with the Laker product management team and IT. Creating maintaining and executing on the product(s) strategic vision and roadmap by serving as a trusted partner to business and technical owners including but not limited to Operations Clinical Account/Client Management IT and Customer Service.

The positions focus will be to lead the creation and support of key adjudication products from inception to execution and document and prioritize critical product features that impact bottom line performance. Working across the organization the Principal Adjudication Product Management focuses on delivering products that provide meaningful value to users and customers of our PBM and Software as a Service (SaaS) offerings. Works with a range of internal partners and external partners gathering their perspectives throughout product roadmap creation and evolution.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• This position is responsible for leading the strategy and execution of product enhancements and end-of-life planning for existing claims and adjudication products and services from concept through deployment. Ensures products and services are successful meet corporate operational excellence criteria and support revenue goals.
• Leads the research development and implementation of adjudication products and services. Identifies analyzes monitors and suggests actions for products and services that materially contribute to overall mission and strategy of the company.
• Evaluates new product development opportunities and existing product enhancements based on regulatory and/or client need. Leads product feature prioritization with business and technical stakeholders to ensure product features are prioritized appropriately.
• Develop business cases from internal and external clients for new product builds or enhancements of existing products. Collaborate with IT stakeholders to obtain high level and detailed budget estimates to support business cases and system development.
• Leads the conceptualization design product development and implementation of approved new and expanded products & services utilizing industry standard methodologies for product lifecycle management. Working with business owners IT stakeholders and Product Readiness to ensure proper product documentation and testing of systems before solutions are moved to the production environment including that required for product release training and postproduction support.
• Responsible for the execution of simultaneous products under development from product concept and approval through deployment. This will include ownership or support of product strategy definition and roadmap; development of marketing and product requirements documents with prioritized features and corresponding justification in partnership with business owners and technical stakeholders; prototype development; and development of strong voice of the customer and competitive intelligence. This position will interface with other areas within the company including but not limited to IT Sales & Marketing Operations Finance/Analytics and Project Management.
• Provides product management oversight for assigned products and services including annual strategic product planning; revenue and expense budgeting and forecasting; pricing; support of product and sales material development; product training assessment and support; RFP support; and product demonstrations.
• Serves as the primary subject matter expert for cross functional business units for claims and adjudication product development and management.
• Conducts market and regulatory analysis by retrieving information from a variety of sources including but not limited to proprietary databases Internet focus groups and other data sources. Utilizes information retrieved to conduct research and analysis and presents results to leadership and product teams.
• Completes all documentation throughout the product or project lifecycle including creating business cases business plans business requirements and product roadmaps.

Supervisory Responsibilities

May Manage assigned staff in the segment area. Responsible for the overall direction coordination and evaluation of the unit. Carries out supervisory responsibilities in accordance with the organizations policies and applicable laws. Responsibilities include interviewing hiring and training employees; planning assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. Supports and enforces all company policies and procedures in a fair and consistent manner taking corrective action whenever necessary.

Client Responsibilities

This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.

Qualifications

To perform this job successfully an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge skill and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience

BA/BS Degree; 8 years related experience and 8 years of SME in respective area(s); (or equivalent combination of education and experience) with at least 4 years leading individual contributors and leaders of leaders; which may be substituted with an appropriate mix of leadership experience and 5 years of MedImpact experience plus an appropriate external leadership training program and internal mentorship with a seasoned leader (VP level) that must completed within 12 months in new position.

Computer Skills

To perform this job successfully an individual should have knowledge of Microsoft Office Suite Microsoft Project and a working knowledge of systems platforms and new technologies.

Certificates Licenses Registrations

Product Management Certification (e.g. AIPMM PDMA Pragmatic Institute) preferred.

Project Management Professional and Certified Scrum Master certification preferred.

NCT-NCPDP Telecommunication Standard certification required

Other Skills and Abilities

• Previous new product development and product management experience required preferably in health information technology or a closely related field.
• Prior pharmacy benefits management disease management healthcare or managed care environment experience.
• Experience in more than one of the following disciplines a plus: Technology Management Medicare Compliance or Operations.
• Subject matter expertise in claims and adjudication product and project lifecycle management and methodologies continuous quality improvement and change management.
• Knowledgeable in marketing including market research market sizing targeting pricing marketing communications sales training and product launch.
• Thorough knowledge of IT systems applications databases architecture and software development lifecycle computer engineering including experience working with modern software development methodologies and enterprise systems architectures.
• Active membership in National Council for Prescription Drug Programs (NCPDP) with participation in relevant standards development Work Groups and Task Groups
• General knowledge of finance including ability to read and understand financial data such as product income statements ROI analysis net-present value analysis.
• General knowledge of operations including scheduling test engineering and quality systems preferred.
• Knowledge and experience with Agile product and project management methodologies a must.
• Clear track record for achieving goals and deliverables that meet revenue goals.

Reasoning Ability

• Ability to define problems collect data establish facts and draw valid conclusions.

• Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.

Mathematical Skills

• Ability to calculate figures and amounts such as discounts interest commissions proportions percentages area circumference and volume. Ability to apply concepts of basic algebra and geometry.

• Ability to apply mathematical operations to such tasks as frequency distribution determination of test reliability and validity analysis of variance correlation techniques sampling theory and factor analysis.

Language Skills

• Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.

• Ability to respond to common inquiries or complaints from customers regulatory agencies or members of the business community.

Competencies To perform the job successfully an individual should demonstrate the following competencies: