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The Health Initiative Senior Director, Health Plans

Role overview

Qualifications

  • Deep understanding of health plans’ business model and operating context
  • Fluency in Medicare, Medicaid, and commercial payment policy
  • Track record of excellence in strategic planning and resource prioritization
  • Experience leading a division or team with cross-functional members

Responsibilities

  • Lead THI's work to activate health plans to invest in drivers of health
  • Engage with health plans’ executive and analytic teams to achieve business goals
  • Define annual and multi-year goals for THI's engagement with health plans
  • Support identification and recruitment of health plan partners for THI

Key facts

  • Remote from: United States
  • Full time
  • Senior (5-10 years)
  • 42 - 190K yearly
  • English

Other skills

  • Strategic Planning
  • Persuasive Communication
  • Creative Problem Solving
  • Communication
  • Teamwork
  • Adaptability
  • Accountability

About the company

Positively Partners logo

Positively Partners

Human Resources Services

Positively Partners specializes in HR outsourcing, management consulting and executive search. We believe that organizations succeed when leaders invest in building pro-social, inclusive, and collaborative workplaces. Through genuine partnership, curiosity, and a commitment to shared learning, we help organizations adopt evidence-based approaches to recruitment, people management, and HR operations.

Company details

Company typeStartup
IndustryHuman Resources Services
Company size11 - 50

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Job description

THE HEALTH INITIATIVE

SENIOR DIRECTOR, HEALTH PLANS

The Context

It is well-established that 80% of a person’s health is determined by factors outside the doctor’s office — healthy food, safe housing and a decent income. Yet our healthcare system is built backwards, with more than 99% of US healthcare dollars spent on medical care alone. The amount of money going toward healthcare is huge — with public and private payers spending over $11B on healthcare every day. This is projected to grow 6% annually through the next decade.

But what exactly do we get for all this healthcare spending? Right now, the US has some of the worst health outcomes across all high-income countries, including for preventable heart disease and obesity, which cost the system nearly $500B each year.  This is inefficient and leaves people behind, especially low-income children and families. 

Imagine a system designed to pay for health, not simply healthcare. What if it invested dollars more efficiently and effectively to pay for access to nutritious food or safe housing as key levers to prevent and manage disease and lower healthcare costs?

The result would be a win-win-win: Children and adults would have better access to healthy food and safe housing and, as a result, have better health outcomes. When healthier patients use less care, the government saves money – and insurance companies’ revenues increase – incentivizing both to pay for these basics.  

The Health Initiative Approach & Impact to Date

The Health Initiative (THI) is a national organization that crosses political divides, taps market forces and activates stakeholders to shift dollars toward health.

By providing strategic guidance and technical assistance, we activate healthcare institutions to redesign their policies and invest preventatively in nutritious food and safe housing— to improve health outcomes for those most at risk and reduce overall healthcare costs. To date, these institutions have spent nearly $1B in healthcare dollars on food, housing and other basics.

For example, THI supported North Carolina to use Medicaid dollars to provide patients with groceries, rental assistance and other basics, keeping them out of the hospital and saving the state a net $1,020 per person per year. CMS incorporated aspects of NC’s approach into its approval process for states to use Medicaid dollars for food and housing benefits and 22 states have enacted key elements of it.

Likewise, THI worked with CMS leadership to lay the foundation for its enacting the first-ever billing codes to pay healthcare providers to screen patients for food, housing, and other basics, and to pay community health workers to navigate patients to these resources.

Finally, with THI’s guidance, three major insurance companies invested over $300M in buying health for their patients and/or their low-wage employees. For example, THI advised a Fortune 50 insurance company on how to increase healthy food and housing benefits by $80M for high-risk patients and to design an evaluation which found that those receiving higher benefits have lower healthcare costs.

Job Purpose

The Senior Director - Health Plans is a key member of the THI Leadership Team and is responsible for engaging health plans with Medicare, Medicaid, Marketplace, and/or commercial members, with the goal of unlocking existing healthcare dollars to invest in healthy food, safe housing, and other drivers of health. This role will be both creative in envisioning how plans can achieve this goal as not just the right, but also the economic thing to do, and persuasive in communicating this approach to others.

The Senior Director - Health Plans may or may not have direct reports but will be responsible for leading a cross-functional team of both THI’s program staff and cross-cutting functions (including research and analytics, communications, and mobilization) to achieve these goals.

This role will also collaborate closely with their peers leading THI’s work to spur federal and state healthcare institutions to invest in drivers of health and to engage philanthropic partners who invest in and champion THI’s work. The position reports to the Chief Operating Officer on an interim basis, and works closely with the Co-Founders and Co-CEOs.

Key Responsibilities

  • Lead THI’s work to activate health plans to invest in the drivers of health as a core part of the business, by engaging plan leaders to implement this approach, build the business case, and go on the record to build sector momentum.

  • Engage directly – and support other THI leaders to engage – the health plans’ executive, product, actuarial, analytic, communications, government affairs, and drivers of health teams to achieve these goals.

  • Identify key stakeholders and the messages/content/analyses that will compel them to act, including overseeing the development and execution of high-quality deliverables.

  • Define annual and multi-year goals for THI’s work with health plans; create and execute plans to achieve those goals; set and evolve priorities; and manage tradeoffs among them.

  • Direct and develop a high-performing, collaborative team to execute on these goals, including effectively using cross-cutting capabilities such as communications, mobilization, and research and analytics.

  • Support identification and recruitment of potential health plan partners for THI and, as appropriate, secure contractual agreements to enable THI to conduct its work most effectively.

  • Actively participate in the THI Leadership Team to strengthen organization-wide operations and culture.

Key Competencies

  • Deep, first-hand understanding of health plans’ business model, operating context, priorities, culture, and approach to engaging policymakers, members, investors, and other stakeholders.

  • Prior employment at a health plan or in a federal policymaking role with direct engagement of senior health plan leadership.

  • Fluency in Medicare, Medicaid, and commercial payment policy required; involvement with bid development for the Medicare Advantage and/or Medicaid markets preferred.

  • Track record of excellence in strategic planning, resource prioritization, and making tradeoffs in a fast-paced, rapidly evolving environment.

  • Best-in-class at understanding and effectively engaging with others’ motivations, including the ability to know when and how to inspire, challenge, and collaborate, including at the executive level.

  • Ability to understand current constraints; think creatively about how to achieve THI’s objectives within these or to alter them; and persuade others to take action consistent with this approach.

  • Ability and experience influencing outcomes through establishing credibility, building trusting relationships, and persuasive written and oral communication, rather than through formal authority.

  • Experience supporting senior executives/leaders; leading change management efforts in complex environments; and facilitating multi-stakeholder engagements.

  • Experience leading a division or team, ideally with cross-functional team members.

CORE THI ATTRIBUTES AND BEHAVIORS:

  • Commitment to THI’s mission, vision, and values.

  • Continuous improvement mindset; curiosity and eagerness for learning and feedback.

  • Confident in leading with a point of view and recommendations while being open to changing position when necessary.

  • Takes full accountability for functional team goals, deliverables, and team performance amidst change.

  • Ability to navigate ambiguity, work independently and collaboratively, and know when to seek input.

  • Ability and willingness to learn and adapt to THI’s approach to building transformative relationships based on humility, reliability, openness, humor, and confidence.

  • Clear, concise, and compelling communication.

  • Strong prioritization skills and ability to manage multiple projects concurrently with short, medium, and long-term deadlines.

  • Ability to manage up, down, and with peers.

COMPENSATION AND BENEFITS:

In addition to a competitive salary, THI also offers a generous, comprehensive benefits package including:

  • Full coverage of medical, dental, and vision insurance.

  • Generous 401K matching and parental leave.

  • Unlimited sustainable vacation and sick time.

This is a full-time, exempt role and is fully remote within the US. THI expects staff to work eastern time zone hours. Travel and flexible evening and weekend work expected.

EQUAL OPPORTUNITY STATEMENT:

THI is an equal opportunity employer. We welcome and encourage all qualified applicants to apply.

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Marcus Rivera

Chief Revenue Officer

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