Head of Strategy (Remote)

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are at the forefront of transformation with one of the world’s leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage. Our work centers on creating an exceptional member experience – a commitment that starts with our employees. We are pleased to offer competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more.

Reporting to the Vice President, Medicaid, the Director, Medicaid Strategy will be responsible for development and successful execution of ACO strategies to improve member outcomes and drive financial performance. To ensure the optimal performance on the ACO line of business, the ideal candidate must have strong and proven leadership skills, exceptional analytic thinking, experience with MassHealth, understanding of value-based care and current Medicaid policy. This role will interface with MassHealth as well as provider partners to optimize MGB ACO performance in the Medicaid contract. The Director, Medicaid Strategy must be an innovative and collaborative leader with a high level of strategic focus. This position requires in-depth understanding of current MassHealth contractual requirements such as the primary care sub-capitation program, network requirements, care management and flexible services programs. Additionally, the candidate must possess a strong understanding of MassHealth financing structure and levers to drive performance. This position requires an understanding of current Medicaid policy and how these policies are evolving to anticipate impacts to Mass General Brigham Health Plan’s Medicaid business. This role collaborates with internal departments including Network Management, Medical Economics, Actuarial, Finance, Data Analytics, Risk Adjustment, Population Health, Enterprise Project Management, Utilization Management, Quality and Customer Service.

Develop strategic plans for the Medicaid business that are in line with Mass General Brigham Health Plan, MGB ACO and MassHealth priorities to position the ACO for success

Partner with medical economics, clinical teams and MGB Population Health to develop strategies to manage medical trend

Drive and influence Quality and Health Equity Performance to maximize member health outcomes and incentive payments from MassHealth

Monitor and evaluate financial performance metrics, including medical cost trends, risk adjustment and quality/health equity incentives

Prepare and present reports to leadership highlighting performance trends including areas of opportunity and risk

Work across organization lines to make needs known, collaborate on and influence policies, strategies and plans critical for Medicaid business success; significant cross-functional collaboration is required with Clinical, Quality, IT, Compliance and Government/Regulatory Affairs

Provide insights to the Clinical group about programs and how they meet contractual, financial and market expectations; recommend enhancements and changes as needed to improve performance

Develop and manage relationships with external business partners/potential partners including MassHealth, Mass General Brigham ACO, key provider partners in the network, trade organizations, etc.

Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people‑first organization

Education Bachelor's Degree required

Experience At least 8-10 years of Healthcare Business Development experience required

Experience in Medicaid regulation, policies, and procedures highly preferred

Proficient knowledge of government program policies (Medicare/Medicaid/Dual Eligible), requirements, regulations, and reimbursement models. Proven track record in strategic planning, business development, leadership, and financial management. Exceptional communication and relationship‑building abilities. This is a Monday‑Friday role with standard business hours (in Eastern time)

Remote workspace requirements, including privacy and security standards, may be verified in accordance with organizational policy

Remote Type Hybrid Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $124,342.40 - $180,897.60/Annual Grade 9

Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth.

8925 Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americas with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at View phone number on click.appcast.io.

At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People‑Focused, half Performance‑Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

Help people. Mass General Brigham is a passionate, welcoming community where minds meet caring hearts. Built on the legacy of two leading academic medical centers, we’re more than a system—we’re leaders in the practice of medicine. Mass General Brigham is committed to serving the community. We recognize that increasing value and continuously improving quality are essential to maintaining excellence.

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