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Director, Employer Segments (Healthcare Product Operations)

EmblemHealth New York, NY

New York, NY

Today

$113k - $211k/yr Full time Aso Employer Segments Healthcare Employer

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Job Description

EmblemHealth is seeking a Director to operationalize employer segment product strategy across multiple lines, from Fully Insured (Large Group and Small Group) to ASO/Self-Insured and Level Funded offerings, plus ancillary products. In this onsite role in New York, the Director leads product delivery, benefit design standards, regulatory filing strategy, and cross-functional execution to bring market-ready, compliant products to launch-ready state.

What you’ll do

Drive employer segment product delivery and implementation across Large Group Fully Insured, Small Group Fully Insured, ASO/Self-Insured, Level Funded, and Ancillary products.
Define a multi-year product roadmap aligned to GM’s P&L priorities, growth targets, and competitive positioning.
Lead ASO product management and operations with deep subject matter expertise in self-funded employee benefits.
Set ASO standard versus non-standard guardrails, shape the value proposition, and influence the service model in partnership with functions that own components (admin services, reporting, stop loss, care management).
Own benefit design standards and the regulatory filing strategy for the employer book.
Set medical benefit templates, plan structures, and network configurations for LG FI and SG FI.
Ensure employer products are rate-able, DFS compliant, and aligned with actuarial pricing assumptions.
Lead and hold accountable a team across ASO Products, FI & SG Products, and Ancillary.
Establish clear role expectations, provide coaching and development, conduct performance reviews, and build a high-performing product team capable of executing across all employer LOBs.
Partner with GM, Employer Segment, and Sales leadership to translate employer market priorities into product direction.
Support RFP responses, broker strategy, and account-level product decisions.
Bring product expertise into go-to-market conversations and ensure Sales has competitive, accurate product positioning.
Collaborate on employer product growth efforts, including ASO expansion, SG retention, and deeper ancillary product adoption within the existing employer book.
Coordinate cross-functionally across Actuary, Legal, Compliance, IT, Network, Operations, Communications, and more to move products from design to launch-ready state.
Serve as the primary decision-maker and escalation point for employer product issues.
Represent the employer product function in executive forums and regulatory discussions.
Translate department employer segment business priorities into market-ready, financially sound, and operationally executable product designs, ensuring accountability for on-time delivery, regulatory readiness, and product quality across the full employer book.
Partner with sales leadership in client-facing presentations as the product subject matter expert, answering questions and articulating technical and operational details in real time.

Qualifications

Bachelor’s degree in Business, Health Administration, Public Health, Finance, or related field (required).
12+ years of experience in health insurance product management (minimum experience listed).
10–12+ years of progressive experience in health insurance product management (required).
5+ years of experience at a Director or senior leadership level (required).
Deep ASO/self-funded product expertise, including hands-on experience designing and managing ASO product platforms, service models, stop-loss structures, and employer-specific configurations in a regulated health plan environment (required).
Fully Insured product experience across Large Group and/or Small Group markets, including benefit design, ACA compliance, DFS filing requirements, and community rating rules in New York (required).
Proven experience leading a team of product professionals, including hiring, developing, and holding accountable Leaders or Senior Managers (required).
Strong cross-functional partnership skills with Actuarial, Sales, Legal, Compliance, Network, and Operations (required).
Regulatory knowledge of New York market requirements, including DFS, ACA, ERISA, and NYS DFS rate filing processes (required).
Exceptional communication skills, with the ability to present product strategy to executive leadership, Sales leadership, and external stakeholders (required).
Master’s degree (MBA, MHA, MPH) strongly preferred.
Ancillary product experience (Dental, Vision, Rx) preferred.

Role details

Location: New York, NY (onsite)
Salary: USD 113,400–210,600 per year
Requisition ID: 1000003371

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