Product and Regulatory Implementation Manager

Job Details

The Product & Regulatory Implementation Manager leads the end-to-end implementation of health plan products strategic initiatives and regulatory requirements across all lines of business and the Jefferson enterprise. This role ensures initiatives are delivered on time within budget and in compliance with regulatory standards while coordinating activities across operational technology product and compliance functions. By translating strategic and regulatory requirements into operational execution the position supports organizational goals regulatory readiness and high-quality member and business outcomes.

Job Description

Summary
The Product & Regulatory Implementation Manager leads the end-to-end implementation of health plan products strategic initiatives and regulatory requirements across all lines of business and the Jefferson enterprise. This role ensures initiatives are delivered on time within budget and in compliance with regulatory standards while coordinating activities across operational technology product and compliance functions. By translating strategic and regulatory requirements into operational execution the position supports organizational goals regulatory readiness and high-quality member and business outcomes.

Job Duties

• Lead end-to-end implementation of products regulatory requirements and initiatives across internal systems and external platforms.
• Act as the primary point of contact for internal teams clients and external partners providing regular updates and addressing any challenges during the implementation process. Develop and maintain strong relationships with key stakeholders.
• Develop and maintain implementation documentation process workflows training materials and client-facing resources.
• Serve as the subject matter expert (SME) for initiatives and applicable requirements.
• Translate product and regulatory requirements into actionable workplans timelines and deliverables.
• Collaborate with product and regulatory teams to define scope and ensure alignment of implementation activities with business objectives.
• Coordinate with operations and IS&T teams to define system requirements support configuration oversee integration efforts and validate data flows across platforms.
• Manage cross-functional teams facilitating status meetings documenting progress and addressing risks and dependencies.
• Provide post-implementation support including issue resolution performance monitoring and continuous process improvement.
• Serve as primary liaison between business operations and IS&T ensuring clear communication of requirements timelines and impacts.
• Identify potential risks or barriers to successful implementation including operational and technical risks and proactively develop strategies to address them. Implement contingency plans to minimize impact on implementation timelines and outcomes.

Minimum Qualifications

• Bachelors Degree Business Administration Healthcare Management or a related field
• 5 years Product Development Regulatory Implementation and/or Project Management preferably within the healthcare industry
• Project Management: Demonstrated expertise in managing complex projects from inception to completion including planning execution monitoring and closing phases. Proficiency in project management tools such as Microsoft Project Jira or similar software.
• Cross-Functional Work Groups: Proven ability to work effectively with cross-functional teams including product development operations compliance marketing and IT. Strong collaboration skills to ensure alignment and successful implementation of products.
• IS&T / Systems Knowledge: Experience with system integration data migration and end-to-end testing (SIT/UAT). Ability to partner effectively with IT teams to translate business requirements into technical specifications.
• Demonstrated understanding of health plan operations and supporting systems including enrollment claims billing and customer service platforms.

Preferred Qualifications

• Masters Degree
• Knowledge of Product Timelines and Regulations: Understanding of CMS (Centers for Medicare & Medicaid Services) bid submission Pennsylvania Insurance Department (PID) and Pennie filing timelines and Medicaid HealthChoices and CHIP program agreement processes and regulations.
• Innovative Benefits and Services: Experience with innovative benefits and services such as OTC/Flex Card Transportation etc.
• PMP - Project Management Professional - Project Management Institute

Additional Qualifications

Physical Demands
Lift and carry 25 lbs. frequent sitting/standing frequent keyboard use *patient care providers may be required to perform activities specific to their role including kneeling bending squatting and performing CPR.

Job Description Disclaimer: This position description provides the major duties/responsibilities requirements and working conditions for the position. It is intended to be an accurate reflection of the current position however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.

Work Shift

Workday Day (United States of America)

Worker Sub Type

Regular

Employee Entity

Health Partners Plans Inc.

Primary Location Address

1101 Market Philadelphia Pennsylvania United States of America

Nationally ranked Jefferson which is principally located in the greater Philadelphia region Lehigh Valley and Northeastern Pennsylvania and southern New Jersey is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65000 people strong dedicated to providing the highest-quality compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrows professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic clinical and applied research. Thomas Jefferson University home of Sidney Kimmel Medical College Jefferson College of Nursing and the Kanbar College of Design Engineering and Commerce dates back to 1824 and today comprises 10 colleges and three schools offering 200 undergraduate and graduate programs to more than 8300 students. Jefferson Health nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.

Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age race color religion creed sexual orientation gender gender identity marital status pregnancy national origin ancestry citizenship military status veteran status handicap or disability or any other protected group or status.

Benefits

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues including medical (including prescription) supplemental insurance dental vision life and AD&D insurance short- and long-term disability flexible spending accounts retirement plans tuition assistance as well as voluntary benefits which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues including those who work less than part-time(including per diemcolleagues adjunct faculty and Jeff Temps) have access to medical (including prescription) insurance.

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