Lead Insurance Product Manager - Part D/PDP

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Humana is seeking a Medicare Part D expert to join the team as a Lead Insurance Product Manager who is ready to shape PDP strategy, guide complex decisions and turn regulatory requirements into executable products. As Lead Insurance Product Manager for PDP Strategy & Execution, you’ll serve as the product lead for Humana’s standalone Prescription Drug Plan portfolio. You’ll connect Medicare Part D strategy to accurate, compliant and timely execution across the full product lifecycle, from early market and regulatory assessment through bid development, filing, implementation and annual readiness.

You’ll bring together Product, Pharmacy, Actuarial, Finance, Regulatory Compliance, Legal, Operations, Marketing, Sales, Digital, member communications and program delivery partners to make complex decisions, resolve competing priorities and translate approved strategy into a clear execution path. You’ll assess member, regulatory, financial and operational tradeoffs and provide recommendations that help leaders make informed decisions.

This role is designed for an advanced individual contributor who operates with significant independence, leads through expertise and influence, and raises the standard for PDP product management. You’ll guide other associates and work groups, establish methods and priorities for complex initiatives, strengthen governance and reusable tools, and build shared capability so critical knowledge and accountability extend beyond one subject matter expert.

Key Role Functions

Shape PDP Portfolio Strategy and Direction

• •Lead year-round PDP product strategy and execution, translating enterprise priorities, customer needs, market dynamics, regulatory requirements and financial considerations into actionable portfolio recommendations
• •Integrate competitive, financial, regulatory, operational and member insights to evaluate product opportunities, risks and tradeoffs
• •Analyze competitor participation, premiums, deductibles, cost sharing, formulary positioning and emerging market trends to identify implications for Humana’s PDP portfolio
• •Develop recommendations for new or enhanced benefits, product features and market approaches, including the business rationale, member impact, operational dependencies, risks and implementation path
• •Look beyond the immediate bid cycle to anticipate future portfolio needs, policy changes and market shifts and position partners for effective execution
• •Represent PDP Product Management in strategy and leadership forums, communicating the recommendation, supporting insights, tradeoffs and decisions needed

Lead PDP Bid, Benchmark and Filing Execution

• •Lead product strategy and readiness across the annual PDP bid cycle, including benefit design coordination, bid submission readiness, PBP Section Rx and HPMS activities, validation resolution and alignment across key functions
• •Coordinate benchmark, de minimis, rebate reallocation, desk review and related PDP activities, ensuring impacts, options, decisions and accountable owners are clear
• •Lead review and resolution of filing questions, validation findings, audit exhibits and other CMS submission issues, escalating material product risks at the appropriate time
• •Establish working plans, governance, decision points and controls that support accurate, timely and compliant submissions
• •Maintain clear records of assumptions, decisions, dependencies, risks, status and ownership throughout the bid cycle
• •Provide final product-level review and sign-off for designated PDP submissions and deliverables consistent with established governance

Translate Regulatory Change and Lead Feasibility

• •Interpret CMS guidance and Medicare Part D policy changes and translate them into clear product implications, requirements, decisions and downstream impacts
• •Lead feasibility assessments across product, regulatory, actuarial, financial, pharmacy, operational, technology and member-experience considerations
• •Separate immediate compliance needs from longer-term product opportunities and recommend a practical path forward when guidance or operating conditions are ambiguous
• •Lead Product participation in new Part D opportunities, including CMMI demonstrations and emerging pharmacy programs, from concept evaluation through implementation
• •Identify gaps in products, processes, controls or decision rights; use root-cause analysis to recommend sustainable solutions rather than one-time fixes

Drive Readiness, Implementation and Member Experience

• •Lead annual PDP readiness from bid approval through AEP and January 1 implementation, coordinating milestones, dependencies, issue resolution and leadership-level status reporting
• •Partner with Marketing, Sales, Digital, member-material and operational teams to ensure benefit messaging and product information are accurate, consistent and easy to understand
• •Provide PDP subject matter expertise for product data, member materials, digital tools, training, operational processes and downstream readiness
• •Partner with functional owners to confirm implemented benefits and member-facing information align with approved product decisions and CMS filings
• •Assess readiness and product risk using clear evidence, surface issues early and drive accountable owners toward resolution

Lead SPAP Strategy and Execution

• •Lead PDP Product support for State Pharmaceutical Assistance Program requests for information, evaluations, contracting support and implementations
• •Coordinate product requirements and decisions with state program contacts and internal Legal, Compliance, Pharmacy, Operations, Finance, member communications and implementation partners
• •Assess potential impacts to premiums, LIS coordination, member cost sharing, communications, systems and operational processes
• •Create clarity around scope, decision rights, dependencies and escalation paths and communicate material risks or unresolved decisions to leadership

Strengthen Governance, Quality and Product Capability

• •Establish and maintain standards, controls and reusable tools that strengthen quality, consistency and accountability across PDP strategy, filings and readiness
• •Use data, lessons learned and root-cause analysis to improve processes and reduce recurring defects, rework and unnecessary manual activity
• •Serve as the business subject matter expert for automation and product-data initiatives, translating Part D rules and user needs into practical business requirements and controls
• •Provide functional leadership, coaching and subject matter guidance to Product Managers and cross-functional partners without relying on formal authority
• •Lead associates and work groups in determining methods, analytical approaches, priorities and timelines for complex assignments
• •Build cross-training, documentation and backup coverage so critical knowledge is shared and the organization can operate with greater resilience

Influence Decisions and Lead Through Complexity

• •Facilitate decisions when member, regulatory, financial, operational and market considerations require tradeoffs
• •Exercise independent judgment on complex issues, distinguish material product risk from routine execution matters and escalate appropriately
• •Bring structure to ambiguous work by defining the problem, aligning stakeholders on the outcome and establishing a clear path to resolution
• •Communicate concise, evidence-based recommendations for working teams, senior leaders and executive audiences
• •Build trusted partnerships that allow issues to surface early and support timely, transparent decisions and collective accountability

Key Partnerships & Reporting Relationship

You’ll report to the Director, Insurance Product Management and serve as the primary CPES lead for PDP product strategy and execution. You’ll work closely with leaders and subject matter experts across Pharmacy, Part D Strategy, Actuarial, Finance, Regulatory Compliance, Legal, Operations, Market