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Company: Humana
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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, Marketing, Sales, Digital, Process Improvement & Program Delivery, member communi