SummaCare - 1200 E Market St, Akron, OH
Full-Time / 40 Hours / Days
Hybrid or Remote
Summary :
Responsible for developing and managing the portfolio of plans across all lines of business while evaluating new product opportunities that can differentiate SummaCare and help improve social determinants of health, coverage, and quality of life in the Medicare, Individual and commercial markets. Directs the product development and market intelligence teams to ensure close collaboration with other areas across the organization, including Configuration and HSM in plan and benefit design, and Finance and Sales, to ensure optimization of the financial performance of the plans to support and adhere to business objectives.
Generates insights based on a solid data-backed understanding of the end markets and their pain points, leveraging research and data analysis along the way. Proactively communicates plans to stakeholders and leadership to ensure product solutions are aligned with business goals.
Prepares and executes months long processes to lead a cross functional team in the development of our annual bids for Medicare and Individual Products lines.
Sources all vendor relationships and manages these partnerships for all supplemental benefits for our Medicare and Individual plans for dental, eye, meals, fitness and many other benefits that we offer to these consumers. This would include RFP’s to contract executions and ongoing management of the services, holding the vendors accountable to our standards of service.
Manages the annual development of all Member materials including all that are federally regulated. Follows all of the annual changes that may be mandated by regulators or to follow our planned benefit changes annually.
Formal Education Required :
a. Bachelor’s degree
Experience and Training Required :
a. Five (5) years performing same or similar responsibilities. Relevant experience includes: support of all phases of new product development and implementations in a health insurance/health care environment, research and analysis of insurance/health care related data, and project coordination and support.
b. Past product management and product development experience in health insurance and/ or healthcare.
c. Experience collaborating with others including sales executives, product marketers, researchers, business operations, health services management, contracting, finance, operations, legal, and compliance in defining the product and/or service offering.
Essential Functions :
1. Develops and manages the portfolio of plans across all lines of business to ensure financial optimization and alignment with business goals.
2. Identifies and evaluates new benefits and product opportunities that seek to differentiate SummaCare and help improve social determinants of health, coverage, and quality of life in the Medicare, Individual and commercial markets through collaboration with other leaders within SummaCare and through participation in outside industry groups and discussions. Makes recommendations for new and/ or changes to existing benefits, products and vendors.
3. Identifies and contracts with benefit vendor partners and ensures accurate and timely implementation / renewal and ongoing oversight throughout the year through leading cross- functional teams to coordinate and collaborate. Manages ongoing relationships with these vendor partners and ensures their performance according to contract.
4. Directs the gathering of data, research and market and customer analysis to inform product strategies and decisions, including providing in-depth analysis of key competitors, across all lines of business. Upon request, supports research and market intelligence needs of other areas across the health system.
5. Translates research into actionable insights and develops strategic recommendations. Collaborates with other business leaders to drive decisions based on data, facts and analytical findings. Presents findings to all levels of the organization in a compelling and informative manner.
6. In developing product strategies, understands and reflects unique needs among various end markets such as Medicare Advantage, Individual and Family and employer populations.
7. Leads product development team in designing and evaluating ideas for new products and/or expansion into new customer segments.
8. Serves as subject matter expert on products and benefits across all lines of business. Translates strategy into launch-ready products that work in concert with existing core offerings, are operational, marketable and meet all applicable regulatory and compliance requirements (CMS, ODI, HHS).
9. Creates and provides product and benefit training, content, and guidance to other departments including Sales, Corporate Training, Marketing, and Provider Relations. Gives presentations upon request to educate employees, brokers, providers, members and prospects.
10. Directs the annual submission of the Medicare bid to CMS including the accurate and timely entry of Plan Benefit Designs for Medicare plans and regions using CMS PBP software within regulatory guidelines.
11. Directs the annual Qualified Health Plan (QHP) submission to the Ohio Department of Insurance (ODI) to participate on and off the federal Marketplace and the annual form filings to ODI. Ensures that required plan documents are developed, reviewed, and submitted accurately and timely to Compliance, as applicable, and regulators.
12. Serves as project coordinator for special projects as assigned by Department Vice President or other Senior Leaders as needed.
13. Displays collaborative and dynamic leadership with a commitment to the outstanding member experience.
3. Other Skills, Competencies and Qualifications:
a. Business savvy, with ability to derive product strategy from business strategy.
b. Comfortable working with a small team, but able to scale.
c. Creative and data driven.
d. Non-hierarchical, with a willingness to roll-up your sleeves, multitask and dive into details.
e. Apply principles of logical thinking to define problems, collect data, establish facts, and draw valid conclusions.
f. Demonstrate strong verbal communication and presentation skills.
g. Work effectively and efficiently in a team environment.
h. Organize and manage time to accurately complete tasks within designated time frames in fast-paced environment.
i. Maintain current knowledge of and comply with regulatory and company policies & procedures.
j. Maintain confidentiality of member health and business information.
k. Flexible: ability to adjust work hours to meet business demands.
l. Population Specific Competency: Ability to effectively interact with patients/customers with the understanding of their needs for self-respect and dignity
4. Level of Physical Demands:
a. Light: Exerts up to 20 pounds of force occasionally and/or up to ten pounds of force frequently, and/or a negligible amount of force continuously.
Based in Akron, Ohio, SummaCare provides Medicare Advantage, individual and family and commercial insurance plans. SummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5-Star rating for 2026 by the Centers for Medicare and Medicaid Services (CMS). Known for its excellent customer service and personalized attention to members, SummaCare is committed to building lasting relationships. Employees can expect competitive pay and benefits.
Equal Opportunity Employer/Veterans/Disabled
$66.27/hr - $99.40/hr
The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical.
Summa Health offers a competitive and comprehensive benefits program to include medical, dental, vision, life, paid time off as well as many other benefits.
- Basic Life and Accidental Death & Dismemberment (AD&D)
- Supplemental Life and AD&D
- Dependent Life Insurance
- Short-Term and Long-Term Disability
- Accident Insurance, Hospital Indemnity, and Critical Illness
- Retirement Savings Plan
- Flexible Spending Accounts – Healthcare and Dependent Care
- Employee Assistance Program (EAP)
- Identity Theft Protection
- Pet Insurance
- Education Assistance
- Daily Pay
