Director, Duals Strategy

Mass General Brigham Health Plan
United States, Massachusetts, Somerville
399 Revolution Drive (Show on map)
Feb 21, 2025
Reporting to the Vice President, Dual Eligible Programs, the Director, Duals Strategy will be responsible for development and successful execution of Dual eligible program and product strategies to improve member outcomes, product growth, and financial performance. To ensure optimal performance, they must have strong proven leadership skills, exceptional analytic thinking, experience with Medicaid and/or Medicare, understanding of value-based care and current Medicaid and Medicare policy. The Director, Duals Strategy will lead change efforts by working across the organization at all levels, leading direct reports and matrixed and cross-functional resources. This role will interface with MassHealth as well as key external partners to optimize performance in the D-SNP contracts. The Director, Duals Strategy must be an innovative and collaborative leader with a high level of strategic focus. This position requires in-depth understanding of current D-SNP contractual requirements such as care management requirements, network requirements, quality and health equity incentives, product design and benefits. Additionally, the candidate must possess a strong understanding of D-SNP financing and levers to drive performance, including but not limited to value based and risk sharing arrangements, utilization management, risk adjustment, Medicare Stars and care management, among others. This position requires an understanding of current state and federal policy and how these policies are evolving to anticipate impacts to Mass General Brigham Health Plans Duals business. The Director, Duals Strategy will collaborate with internal departments including, but not limited to, Network Management, Medical Economics, Actuarial, Data Analytics, Risk Adjustment, Enterprise Project Management, Clinical UM, Care Management, Quality and Customer Service. Education Bachelor's Degree Business Administration and Marketing required or Bachelor's Degree Healthcare Management required or Bachelor's Degree Related Field of Study required, plus 7+ years of related experience Can this role accept experience in lieu of a degree? No Licenses and Credentials Experience 7+ years' experience in Medicaid and or Medicare regulation, policies, and procedures. Must have 10+ years of progressive management experience. Experience in healthcare, managed care or healthcare insurance industry required; experience with the MassHealth or dual eligible programs strongly preferred. Supervisory/Management Experience 3-5 years required Knowledge, Skills and Abilities Demonstrate Mass General Brigham Health Plans core brand principles of always listening, challenging conventions, and providing value. Bring fresh ideas forward by listening to and working with employees and the people we serve. Respect the talent and unique contributions of every individual and treat all people in a fair and equitable manner. Strong, demonstrated track record of an ability to execute on time, on budget, and on scope. Strong aptitude for technology-based solutions. Ability to inject energy, when and where it's needed. Current in healthcare trends. Demonstrated forward, visionary thinking; ability to see "what is" and envision "what could be." Ability to develop, introduce, defend, and gain support for a new ideas and approaches. Excellent leadership skills and leadership track record. Ability to translate and communicate complex topics in a variety of forums, tailoring communications to effectively fit and influence the targeted audience, strong executive presence, presentation, and communication skills. Strong verbal, active listening, and written communication skills required. Ability to view the long-range trends and cycles of the business and industry and see the "big picture." Ability to apply a variety of strategic frameworks to analyze problems and to guide and develop solutions. Ability to challenge the status quo and drive innovative thinking and the capability to successfully implement strategy. Excellent interpersonal skills, including the ability to influence others at all levels of an organization. Strong EQ; exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback. Unquestionable integrity. Physical Requirements Standing Occasionally (3-33%) Walking Occasionally (3-33%) Sitting Constantly (67-100%) Lifting Occasionally (3-33%) 20lbs - 35lbs Carrying Occasionally (3-33%) 20lbs - 35lbs Pushing Rarely (Less than 2%) Pulling Rarely (Less than 2%) Climbing Rarely (Less than 2%) Balancing Occasionally (3-33%) Stooping Occasionally (3-33%) Kneeling Rarely (Less than 2%) Crouching Rarely (Less than 2%) Crawling Rarely (Less than 2%) Reaching Occasionally (3-33%) Gross Manipulation (Handling) Constantly (67-100%) Fine Manipulation (Fingering) Frequently (34-66%) Feeling Constantly (67-100%) Foot Use Rarely (Less than 2%) Vision - Far Constantly (67-100%) Vision - Near Constantly (67-100%) Talking Constantly (67-100%) Hearing Constantly (67-100%) Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. 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.