Manager of Product & Pricing

Medical Associates Health Plans is hiring a Manager of Product and Pricing to join our team!

Where You Will Be Working:

Medical Associates Clinic and Health Plans is a multi-specialty group practice combined with a growing health insurance company. Our 1,100 healthcare and health insurance professionals lead the way in providing quality healthcare and top-notch insurance products in Northeast Iowa, Southwest Wisconsin, and Northwest Illinois. This position is an onsite position located at the Medical Associates Health Plans in Dubuque, Iowa.

Benefits Package Includes:

Single or Family Health Insurance with discounted premium rates for wellness program participation. 401k with immediate matching (50% on the dollar up to 7% of pay) + additional annual Profit Sharing Flexible Paid Time Off Program (29 days off/year) Medical and Dependent Care Flex Spending Accounts Life insurance, Long Term Disability Coverage, Short Term Disability Coverage, Dental Insurance, etc.

Major Responsibilities:

Underwriting Management:

Oversee the evaluation of risk for potential and renewal business, ensuring underwriting decisions align with financial goals and company risk appetite.

Provider Contracting:

Lead contract negotiations, drafting, and implementation with healthcare providers to establish reimbursement rates and network structures.

Product Oversight:

Manage product design and specifications to ensure alignment with regulatory requirements, evolving market trends, and financial optimization objectives, including pricing strategy, benefit structure, and competitive positioning.

Compliance & Auditing:

Ensure compliance with state statutes, industry regulations, and internal underwriting guidelines. Manage rate filings and network adequacy requirements.

Strategy & Profitability:

Analyze claims data to identify trends, improve underwriting models, and implement pricing strategies. Develop budget and investigate variances.

Leadership & Strategy:

Manage selection, training, development, performance evaluations, and performance issues of assigned staff. Complete all other assigned projects and duties.

Knowledge and Skills:

Experience Five years to ten years of similar or related experience. Education Equivalent to a college degree. Interpersonal Skills The ability to motivate or influence others is a material part of the job, requiring a significant level of diplomacy and trust. Obtaining cooperation (internally and/or externally) is an important part of the job.