About us:

Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)— in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn.

Brief summary of purpose: 

Reporting to the Director of Product Management, the Product Manager IV (SCO) is responsible for managing the product portfolio for a specific market segment. This role includes developing new product features and enhancements, overseeing portfolio revisions, and managing the product lifecycle to support market position, membership goals, and profitability targets. The Product Manager IV contributes to the development and execution of product strategy and ensures successful implementation across a matrixed organization and with a broad range of external stakeholders, including vendors and regulatory agencies.

This position is self-directed, requires both strategic and operational focus, and involves exposure to all levels of management. The Product Manager IV makes recommendations to leadership regarding product changes that improve competitive positioning, manage costs for members and Fallon Health, streamline internal processes, and enhance the overall consumer experience. The role also requires close collaboration with internal departments, including Sales, Finance, Actuarial, Medicare Compliance, Regulatory, Corporate Communications, IT, Configuration, Provider Network Management, and Customer Service, as well as with external agencies, vendors, providers, and members. 

Responsibilites: 

• Serves as the subject matter expert and primary point of contact for product and product-related issues for the assigned market segment (SCO).
• Assists in defining the product strategy and roadmap, identifying critical priorities and supporting efforts to drive decision-making.
• Conducts qualitative and quantitative research to inform product design, development, and enhancement.
• Evaluates new product opportunities and growth initiatives, including partnerships, sales and marketing initiatives, and entry into new markets.
• Leads cross-functional assessments to understand the strategic implications and operational requirements associated with new opportunities and initiatives.
• Researches and analyzes national market trends, monitors local competitors, and recommends product improvements.
• Leads cross-functional teams, drives decision-making, and ensures the end-to-end integrity of product implementations.
• Oversees system configuration, marketing collateral, filed materials, and product infrastructure to ensure alignment with product design and intent. Collaborates with internal departments including Sales, Finance, Actuarial, Medicare Compliance, Regulatory, Corporate Communications, IT, Configuration, Network Management, EPMO, and Customer Service, as well as with external vendors and government agencies.
• Supports the annual bid cycle in partnership with the Director of Product Management, Leadership, Sales, Actuarial, Pharmacy, Network Development, Clinical departments, Communications, vendors, and operational stakeholders.
• Monitors and reports on the ongoing performance of assigned products, including profitability, membership growth and retention, operational performance, and member experience.
• Holds the organization accountable for meeting contractual requirements by building and leading teams that implement and improve services and develop solutions to evolving contractual responsibilities.
• Persists in accomplishing objectives to consistently achieve results despite obstacles and setbacks that arise.
• Oversees product vendor strategy and manages day-to-day vendor performance, including performance measurement, configuration, and service levels. Serves as a positive role model within the department.
• Leverages departmental resources to support day-to-day project work and help build team knowledge.
• Other duties as assigned with or without accommodation.  

Experience: 

Minimum of 10 years of experience in a healthcare setting, including at least 7 years in Product Management or Project Management. Managed care experience is required, along with knowledge of plan operations, finance, product implementation, marketing, and product management. Extensive knowledge of Medicare and Medicaid products is required. Proficiency with Microsoft Office, PowerPoint, SharePoint, Excel, and Copilot is preferred

Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.