At AmeriHealth Caritas, we’re passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

About this job:

Responsible for leading the development and enhancement of all new products and specific key strategic initiatives for Medicare. This position owns the end-to-end development of new products. It supports the development of strategy for the Medicare division, including leading the development of market assessments, modeling tools, and business cases. This position leads to assessing new business opportunities by conducting competitive assessments, managing cross-functional work groups to build consensus, developing business cases, and presenting to leadership.

Responsibilities:

• Manage the creation and refresh of long—and near-term performance metrics, goals, and targets, including strategic and financial goals for Medicare.

• Drives evaluation of Medicare product development and new business opportunities; collaborates cross-functionally to assure successful and comprehensive analysis.

• Manage and support creation and updates to business cases for current and target markets.

• Create a documented process to assess new product opportunities, executions, and delivery.

• Gather, analyze, and track quantitative/qualitative data and research on existing and potential markets and create market assessment deliverables (i.e., market pipeline).

• Serve as an internal consultant or strategic evaluator of business initiatives and solutions, such as new products or market entry, strategic partnerships, joint ventures, or acquisitions.

• Own membership projections for new business strategies and products. Leverage internal and external research, as well as knowledge of the competitive environment, to inform assumptions.

• Partner with leadership to pressure test assumptions.

• Manage highly strategic projects or short-term internal consulting engagements aligned with the overall strategy across business areas and functions (e.g., Medicare Rural Strategy).

• Partner with Medicare brand, marketing, and communications teams to develop and execute aligned products with strategic plans.

• Work collaboratively with internal business teams to integrate new products and programs.

• Developing and presenting materials supporting various product and market recommendations.

• Assemble deliverables for internal and external audiences, e.g., product pipeline reports, CMS applications, etc.

• Managing high-level work plans for meeting various deadlines and deliverables.

• Additional duties as assigned.

Education & Qualifications:

• A bachelor’s degree in healthcare, Business Administration, or related area of study or equivalent combination of education and/or relevant work experience.

• Master’s Degree preferred.

• 3 to 5 years of work experience in business development, product development, marketing, or managed care.

• 3 to 5 years experience in project management or in a strategic capacity.

• Proven experience developing strategic initiatives that align with business goals and budget; experience with financial modeling and return-on-investment analysis.

• Ability to organize, analyze, and synthesize large sets of qualitative and quantitative information to influence strategic decisions.

• Experience in diagnosing, isolating, and resolving complex issues and recommending and implementing problem-solving strategies.

• Experience collaborating with internal and external resources to develop strategies that meet departmental goals within budget and established timelines.

• Strong communication and presentation skills.

• Demonstrated ability to manage multiple priorities and deadlines.

• Understanding and experience with the Medicare program; knowledge of Medicare Part D preferred.

• Proficient in Microsoft Office and industry-related software programs.

• Configuration management which includes identifying and coordinating the State (MIPPA/SMAC) CMS agreement requirements for the individual components of Medicare products.

• Planned and executed configuration management throughout the lifecycle of a project.

• Work with configuration teams to identify and implement configuration requirements.

• Analyze issues related to configuration.

• Propose solutions to any issues.

Diversity, Equity, and Inclusion

At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable being themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits Package

Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k) tuition reimbursement, and more.

As a company, we support internal diversity through:

Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.