Director, Medicare Product Strategy

About the role

Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We've had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it's at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work. We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about who we are at Point32Health . Job Summary The Director is responsible for the overall success of Point32Health's Medicare offerings, including the Medicare Advantage and Medicare Supplement product lines. In addition to managing existing products and markets, the Director will lead or play a key role in the evaluation of potential market expansion opportunities, and subsequent implementation. The Director is accountable for profit and loss results, membership growth and retention, medical and administrative expense targets, and regulatory/compliance requirements. The Director leads a team that establishes, implements, and performance manages product strategies across a highly matrixed organization, and externally, with a broad set of stakeholders (e.g., providers, brokers, vendors, etc.) Key elements of the product strategy include, but are not limited to, product design, margin targets, membership targets (sales and retention), competitive positioning, marketing strategy, care management model, and provider network. The Director is responsible for ensuring identification of the deliverables necessary to achieve the strategy and coordinating with leaders across the organization to facilitate implementation. The Director is responsible for establishing a management structure that monitors the performance of the chosen strategies relative to established targets, including identifying key performance indicators. The Director works closely with a cross-section of functional teams (sales, operations, clinical services, population health, quality, network management, legal, compliance, finance, marketing, etc.) to establish shared accountability for the achievement of these performance objectives. For potential expansion markets, the Director will coordinate a robust evaluation of market potential (growth/financial) including the competitive landscape, provider environment, etc., and develop the product strategy recommendation for senior leadership. Across existing and potential new markets, the Director is responsible for establishing and maintaining productive relationships with senior leaders of strategic partners, including but not limited to providers, regulators, advocates, and vendors. Job Description Develop multi-year market strategy. Ensure the implementation of initiatives critical to strategic success, including the management of strategic partner relationships and/or internal performance improvement projects. Establish key performance objectives, monitor results, and coordinate data-driven strategic recommendations across a variety of domains including medical trend, financial and operational performance, member/provider experience, care management, network management and quality. Coordinate closely with enterprise leaders, including medical and care management leadership, actuarial, operations, sales, marketing, network contracting, on the achievement of shared objectives. Develop recommendations to optimize ongoing product positioning based on market data, business, and competitive intelligence data. Develop productive working relationships with a wide variety of external stakeholders, including providers, regulators, and advocates. Communicate product performance to internal stakeholders, including senior leadership. Evaluate potential near-term opportunities, including alongside potential strategic partners. Develop and present strategic recommendations to senior leadership for feedback and approval. Develop cross functional relationships to support the strategy setting and execution. Salary Range $176,540.80 -$264,811.20 Compensation & Total Rewards Overview The annual base salary range provided for this position represents a range of salaries for this role and similar roles across the organization. The actual salary for this position will be determined by several factors, including the scope and complexity of the role; the skills, education, training, credentials, and experience of the candidate; as well as internal equity. As part of our