Medicare Product Manager / Specialist

Full-time; US office


HighRoads is the industry leader in sales-enabling health plan product management. Our cloud-based technology empowers our health plan clients to quickly configure and sell innovative compliant products that meet customer needs and differentiate them from the competition.

Position Summary/Scope

HighRoads is hiring for a Medicare Product Manager / Specialist that will report into Product Management. In this role, he/she will be the primary subject matter expert (SME) on the Medicare and Medicare Supplement process and how it relates to the HighRoads’ solution. The Medicare Product Manager / Specialist will be responsible for ensuring the product adheres to the CMS compliance requirements and for identifying additional product capabilities to continuously enhance HighRoads’ Medicare solution.

Responsibilities/Success Factors

Specifically, the Medicare Product Manager / Specialist will be expected to:

  • Own the Medicare product capability and serve as the organization’s subject matter expert (SME) on Medicare Advantage.
  • Understand and interpret the relevant CMS compliance requirements’ and ensure that the product adheres to those requirements.
  • Understand and contribute to the development of the product roadmap as it relates to expanding the Medicare product capabilities based on market needs and drivers.
  • Write detailed functional specifications, for use by both technical and non-technical readers, that describe business transaction functionality and use cases related to Medicare Advantage programs.
  • Develop content for product training material.
  • Participate in sales demos as a SME for Medicare Advantage.
  • Support UAT.

Ideal Qualifications

  • Previous experience working in the healthcare payer industry is required.
  • A minimum of 5 years of experience working in a role that requires a deep understanding of Medicare Advantage and Medicare Supplement products. Experience with PBP tools, member documents such as ANOC, EOCs, SBs, MMP Handbooks, and experience with the CMS PBP, Annual bid submission process.
  • Deep knowledge of the Medicare Advantage program and the payer business processes associated with it.
  • Applied experience in Agile teams and applying continuous improvement practices.
  • Demonstrable experience building detailed functional specifications for use by both technical and non-technical readers.
  • Experience with cloud development and cloud infrastructures.
  • Understanding of web-oriented design best practices and principles.
  • Strong interpersonal, problem solving and situation analysis skills.
  • Expert understanding of SaaS platform capabilities and partner tools.
  • Bachelor’s Degree in a technical/business discipline.

Ideal Personal Characteristics

  • A Focus on Execution. A self-starter with a bias for action. A non-political team player who can quickly establish himself/herself as a trusted member of the team and can be relied upon to get things done.
  • Company Focused. Someone who identifies closely with and is committed to the achievement of the Company’s mission while working in concert with other groups internally and externally.
  • Nimble in the Face of Ambiguity and Adversity. Grounded/pragmatic; someone who naturally adjusts to changing internal/external dynamics, priorities and challenges. Decisive optimist / “can-do” attitude; values people and focuses on “doing the right thing”.
  • Energetic and Optimistic. HighRoads is a dynamic, innovative company with a “can-do” culture. It wants team members who continue to build on this culture.
  • “Equity” Mindset. The successful candidate will have a proven ability to pursue his/her objectives passionately with an ownership mentality and a focus on the overall success of the Company.
  • Maturity and Independence. A highly ethical and intelligent professional who effectively represents the company and its mission internally and externally and who brings enhanced credibility to the firm and its products. A thoroughly honest and forthright individual who is up-front and direct with subordinates, peers and top management executives.


Hiring in Burlington, MA / U.S. Remote

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