PacificSource Health Plans · 2 months ago
Senior Director, Product & Regulatory Management
Bend, OR
Full-time
Hybrid
Director/Executive
8+ years expPacificSource is a health plans company committed to helping members access quality, affordable care. The Senior Director, Product and Regulatory Management is responsible for leading product lifecycle management, ensuring compliance with regulations, and driving strategic initiatives to achieve membership and profitability targets.
CommunitiesCustomer ServiceNon Profit
Responsibilities
Lead the product portfolio development and execution strategy across segments and multiple plan years. Direct the Medicare and Commercial product strategy and portfolio management to ensure profitable growth consistent with business plans. Oversee each step of the work from development to assessment and implementation. Lead, coordinate, and communicate product and lifecycle activities with others in the organization. Oversee successful and timely annual bids, filings, related regulatory submissions, and go-to-market activities
Oversee development and deployment of regulatory communication materials and processes, including Annual Notice of Change, directories, Evidence of Coverage, handbooks, formulary materials, forms, letters, and other regulated materials
Oversee the preparation of all filings and compliant regulatory documents across the product portfolio, including health contracts, self-funded materials, and related documents
Oversee implementation of state and federal benefit mandates, including benefit changes and member communication requirements
Provide strategic advice for PacificSource teams to ensure plan information is accurate and available timely within required timeframes. Ensure proactive communication of new and revised plan designs and benefits to internal stakeholders
Develop and improve processes, driving administrative efficiencies and cost savings, including leading in a matrixed environment and emphasizing execution, market positioning, and operational tactics. Drive operational excellence, sustainability, and profitable growth
Generate local competitive market insights to drive innovation and decision making. Conduct market research, competitive analysis, and financial assessments to evaluate improvement opportunities and business strategies in concert with PacificSource’s enterprise strategy. Implement strategies across segments and markets
Develop structures and processes to ensure compliance, including leading cross-functional teams. Collaborate with Marketing, Sales, Operations, Health Services, and Compliance. Develop strategic business partnerships with internal departments and leaders to ensure strong operating performance, high member satisfaction and quality performance, access, compliance and audit readiness, and sound financial performance
Work closely with Compliance and others to ensure policies, procedures, workflows, lifecycle strategies, product offerings, and success initiatives comply with state and federal regulations. Participate in compliance audits, activities, and planning
Negotiate business relationships with vendors and oversee the execution, implementation, and oversight of the contracts
Develop and monitor departmental budgets and take corrective action as necessary
Provide leadership and mentoring to the enterprise product team, the business administration team, and the regulatory communications team. Foster leadership development and advancement. Develop succession plans. Manage, coach, motivate, and guide employees
Qualification
Required
Minimum of eight years of experience in product, portfolio, lifecycle management, and regulated communications, or substantially equivalent work in highly regulated functions
Exemplary work history with a proven record of success in positions of progressively greater responsibility managing people and achieving business goals and objectives
A solid grasp of the managed care field and insurance regulations is crucial for this role
Experience with strategic planning, communications, sales, product development, regulatory filings, and managing teams required
Leadership experience in a managed care organization requiring advanced knowledge of products, regulatory filings, and regulated communications
Experience with end-to-end product development and lifecycle management of Medicare Advantage, Individual, and group segments, on and off exchange
Experience providing oversight to ensure the successful regulatory filing of all required product materials
Demonstrated success working in a matrixed environment with the ability to set a path and inspire others to follow
Proven record of accomplishment as a driver of process improvement and identifier of efficiency opportunities and ability to lead change
Experience with federal and state regulatory compliance for health insurance plans
Proven ability to quickly assimilate information and make informed decisions; logical, analytical thinker with great influencing abilities; and ability to handle multiple priorities and deal with ambiguity
Bachelor's degree required with a focus in health care administration, business, public policy, public health, or a related field
Advanced knowledge of Medicare Advantage, DSNP, fully insured group business, and Individual, on and off exchange, along with a deep understanding of the key attributes, competencies, and strategies for success
Advanced knowledge of state and federal regulations
Strong understanding of managed care and publicly financed or subsidized health care, including the intersection between retail Medicare Advantage, DSNP, and Medicaid
Demonstrated experience and success in working collaboratively in defining and achieving common goals
Ability to communicate, persuade, influence, and negotiate effectively
Comprehensive knowledge of business principles and administration, organization, and management activities, including knowledge of infrastructure and operational requirements needed to comply with regulatory mandates
Excellent verbal and written communication skills
Solid organizational and problem-solving skills with a keen eye for detail
Proficiency in analyzing market trends, conducting competitive research, and developing strategic product and portfolio roadmaps is essential for success
The ability to multitask, prioritize competing demands, and adapt to a changing regulatory environment is key
Preferred
Master's degree or other advanced degree preferred
Knowledge of self-funding arrangements is preferred but not required
Company
PacificSource Health Plans
Founded in 1933, PacificSource is a not-for-profit health insurer for people and organizations throughout the Northwest.
1001-5000 employees
H1B Sponsorship
PacificSource Health Plans has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (6)
2024 (4)
2023 (2)
2022 (4)
2021 (5)
Funding
Current Stage
Late StageLeadership Team
John Espinola MD MBA
President and CEO
Erick Doolen
Chief Operating Officer
Recent News
2025-11-29
2025-10-22
Company data provided by crunchbase