Summary:

Arcadian Health Plan is a fast growing $400+ million revenue healthcare company that is building a medical economics team to help guide provider partnership initiatives and identify opportunities to improve cost of care.  The Director of Bid Development will be responsible for leading all analytical, cross-functional, and technical aspects of benefit design, pricing and bidding for both Medicare Advantage and Part D product, as well as hiring and managing internal staff, directing actuarial consultants in support off pricing and bidding efforts, and coordinating with all internal departments in gathering relevant input and information for benefit design and bid development. This position will organize, manage and execute the entire Medicare benefit design and bid filing process to successful and timely completion. 

Essential Responsibilities:

·         Manages and supervises the Bid Development staff to ensure accurate, timely completion of all benefit design and bid development steps

·         Develops, coaches, and motivates success by modeling behavior consistent with corporate values

·         Assesses and manages performance of staff 

·         Creates positive environment for staff

·         Organizes and manages the day-to-day responsibilities of the annual Medicare benefit design and bid development process

·         Develops internal staff, knowledge and tools to ensure timely, accurate annual bid development and submission

·         Participates in/supports management strategy discussions regarding products and pricing

·         Interacts with and directs actuarial consultants regarding their work on the Medicare Advantage bid development process

·         Coordinates analysis, discussion and resources across all company departments (Sales, Network, Health Services, Finance, Operations, Compliance) in support of benefit design and pricing

·         Collaborates with the Sales and Marketing team and Network Management team to ensure appropriate positioning of regional and local benefit options.

·         Works in conjunction with Finance team, Actuarial consultants and Chief Actuary to ensure appropriate pricing of admin/benefits and development of BPTs.

·         Coordinates with Compliance team to ensure the proper alignment of benefit categories with PBP categories

·         Monitors, organizes and communicates as needed CMS bid-related guidance, pricing tools and other regulatory information critical to compliance as Medicare Advantage contractor

·         Responsible for timely submission of final bids in compliance with CMS submission requirements and consistent with company business objectives

·         Facilitates and manages CMS bid review responses / audit responses

•     Must have background in health care or managed care and a strong understand of the Medicare business. (5+ years of health plan experience preferred)

•     Extensive experience organizing, leading and successfully completing the Medicare Advantage Bid filing process.  (3+ years experience preferred)

•     Clear understanding of the Medicare HPMS system

•     Experience pricing benefits and contracts. 

•     Exceptional project management skills

•   Strong independent decision-making skills.  Converts strategic direction into specific action plans.

• Skilled at influencing senior level management and key stakeholders
• Significant experience in a work environment requiring substantial interaction with multiple levels of an organization (C-level, direct operations, middle management, and senior management)
• Builds strong cross-functional relationships