Product Manager, Medicare Enrollment & Benefits
New
Fully remote work opportunity within the United States., multiple time zonesFull-TimeManager
Salary132,000 - 141,000 USD per year
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Job Details
- Experience
- 5+ years
- Required Skills
- AgileProduct ManagementSaaS
Requirements
- 5+ years of experience in product management, healthcare payer operations, Medicare benefit administration, or enrollment processing environments.
- Deep knowledge of Medicare Fee-for-Service enrollment workflows, CMS enrollment transactions, and Medicare benefit package structures.
- Proven ability to translate regulatory requirements into detailed product specifications, user stories, and Agile acceptance criteria.
- Strong understanding of accumulator logic, including deductible tracking, out-of-pocket maximums, benefit limits, and multi-claim-type scenarios.
- Familiarity with coordination of benefits (COB) processes and their impact on Medicare benefit configurations.
- Excellent collaboration, communication, and stakeholder management skills across technical and non-technical teams.
- Experience with healthcare payer platforms or core administrative processing systems.
- Knowledge of CMS enrollment reconciliation processes, 834 enrollment transactions, and healthcare SaaS implementation environments.
- Strong analytical mindset with exceptional attention to detail and regulatory compliance requirements.
Responsibilities
- Own and manage product requirements for Medicare Fee-for-Service enrollment workflows, benefit package configuration, and enrollment reconciliation processes.
- Define and maintain system behavior requirements for benefit structures, cost-sharing rules, coverage limitations, and benefit period logic within the payer platform.
- Drive product requirements related to accumulator functionality, including deductibles, out-of-pocket maximums, benefit limits, and coordination of benefits scenarios.
- Analyze CMS rule changes and annual Medicare benefit updates, translating regulatory requirements into structured product enhancements, user stories, and acceptance criteria.
- Maintain a regulatory change calendar aligned with CMS implementation timelines to support efficient product release planning and client readiness.
- Partner with implementation, QA, and client success teams to validate enrollment outputs, benefit configurations, and compliance with CMS expectations.
- Serve as the internal subject matter expert for Medicare enrollment and benefit design, prioritizing and managing regulatory-driven product backlog items.
- Collaborate cross-functionally with engineering and stakeholders to ensure accurate, scalable, and compliant product delivery.
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