Overview

The Executive Director-Product Leader Commercial (Fully-Insured) is responsible for leading the end-to-end commercial (fully-insured) product strategy for IU Health Plans. This includes all elements of the product portfolio including product development, growth and performance. The leader will work with areas across IU Health to ensure the products are designed with competitive benefits that drive growth, quality and capitalize on new care delivery models to optimize product performance. The leader ensures market recognition of the IU Health Plans brand through a data-driven approach to ensure competitive health insurance product pricing. Through advanced knowledge of emerging trends, tiered network products, high-performance networks as well as virtual-only offerings, the leader will enable membership growth with enhanced quality and experience for our members. The leader will adhere to IDOI and CMS program rules, audits, and other regulatory requirements, including delegation oversight of appropriate delegated entities. The leader collaborates to achieve optimal placement and performance of pharmacy benefits; specifically, around formulary development, drug tier placement, cost sharing strategies, and network selection to achieve the highest clinical outcomes and lower member costs. The leader collaborates to prioritize and escalate health plan issues and opportunities. This will include developing a working understanding of internal administrative functions and costs and continuously partnering with operational leadership to assess for efficiencies. Through collaboration, the leader will push in new and various ways for growth and retention opportunities throughout the annual cycle. The product leader will work closely with the sales and the marketing teams on both annual enrollment and also ongoing retention throughout the year. The leader will adhere to NCQA quality program, the role of complete and accurate medical record documentation (for small group products) and the importance of member, broker/consultant, and employer group experience. 

Qualifications/Skills/Experiences:

• Bachelor’s degree required; Master’s degree preferred.
• 10+ years of healthcare experience; prefer prior commercial (fully-insured) product experience and some prior experience with pharmacy benefits management (PBM) oversight or administration.
• Prefer candidates who have experience with integrated (provider/payer) delivery systems and can effectively balance traditional health plans needs with those of the broader health system.
• Must be equally strategic and operational and have a track record of managing and leading teams focused on improvement, insights, strategy, and execution.
• Able to inspire teams, set a vision, drive outcomes and do so through influence (versus authority or direct reporting lines).
• Able to balance multiple competing priorities and deliver.
• Must have demonstrated experience of delivering results in a matrix environment.

We are an equal opportunity employer and value diversity and inclusion at IU Health. IU Health does not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.