Director, Employer Segments (Healthcare Product Operations)

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