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This job was posted by https://idahoworks.gov : For more information, please see: https://idahoworks.gov/jobs/2263517 Looking for a way to make an impact and help people?

Join PacificSource and help our members access quality, affordable care!

PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.

Diversity and Inclusion: PacificSource values the diversity of the people we hire and serve. We are committed to creating a diverse environment and fostering a workplace in which individual differences are appreciated, respected and responded to in ways that fully develop and utilize each person\'s talents and strengths.

The Senior Director, Product and Regulatory Management is responsible for leading teams in three key domains: 1) the development, implementation, and management of the end-to-end product lifecycle for Medicare and commercial lines of business; 2) efficient and effective commercial business administration; and 3) compliant and effective regulatory communications. Working with company leadership, the Senior Director is responsible for developing and implementing products that achieve membership and profitability targets. In support of strategic business plans developed by the leaders responsible for profit and loss of the lines of business, this position ensures the product lifecycles, annual roadmaps, filings, and communications meet business needs. The Senior Director ensures the organization complies with product, filing, and communication-related processes and timelines, as well as manages major milestones, risk and mitigation planning, tracking and reporting, and communication across the organization. The Senior Director leads product strategy, development, the annual bid process, and corresponding initiatives. The product portfolio includes Medicare Advantage, Dual Special Needs Plan (DSNP), fully insured group business, and Individual offerings, on and off exchange, as well as corresponding regulated filings and materials. The communications portfolio supports regulated communications, predominantly for Medicare Advantage, DSNP, and Medicaid plans. The Senior Director manages a leadership team to deliver on this critical work.

Essential Responsibilities:

Lead the product portfolio development and execution strategy across segments and multiple plan years. Direct the Medicare and Commercial product strategy and portfolio management to ensure profitable growth consistent with business plans. Oversee each step of the work from development to assessment and implementation. Lead, coordinate, and communicate product and lifecycle activities with others in the organization. Oversee successful and timely annual bids, filings, related regulatory submissions, and go-to-market activities.

Oversee development and deployment of regulatory communication materials and processes, including Annual Notice of Change, directories, Evidence of Coverage, handbooks, formulary materials, forms, letters, and other regulated materials.

Oversee the preparation of all filings and compliant regulatory documents across the product portfolio, including health contracts, self-funded materials, and related documents.

Oversee implementation of state and federal benefit mandates, including benefit changes and member communication requirements.

Provide strategic advice for PacificSource teams to ensure plan information is accurate and available timely within required timeframes. Ensure proactive communication of new and revised plan designs and benefits to internal stakeholders.

Develop and improve processes, driving administrative efficiencies and cost savings, including leadin in a matrixed environment and emphasizing execution, market positioning, and operational tactics. Drive operational excellence, sustainability, and profitable growth.

Generate local competitive market insights to drive innovation and decision making. Conduct market research, competitive analysis, and financial assessments to evaluate improvement opportunities and business strategies in concert with PacificSource\'s enterprise strategy. Implement strategies across segments and markets.

Develop structures and processes to ensure compliance, including leading cross-functional teams. Collaborate with Marketing, Sales, Operations, Health Services, and Compliance. Develop strategic business partnerships with internal departments and leaders to ensure strong operating performance, high member satisfaction and quality performance, access, compliance and audit readiness, and sound financial performance.

Work closely with Compliance and others to ensure policies, procedures, workflows, lifecycle strategies, product offerings, and success initiatives comply with state and federal regulations. Participate in compliance audits, activities, and planning.

Negotiate business relationships with vendors and oversee the execution, implementation, and oversight of the contracts.

Develop and monitor departmental budgets and take corrective action a