Duals Performance Manager, Product strategy

Who We Are

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. Weve had a long-standing commitment to inclusion and equal healthcare access and outcomes regardless of background; its 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

Job Description

Key Responsibilities/Duties what you will be doing (top five)

Product Strategy & Development

• Lead the design and implementation of product strategies for D-SNPs and other dual-eligible products.
• Analyze federal and state regulations to ensure compliance and alignment with business goals.
• Collaborate with actuarial network clinical and operations teams to develop benefit designs and pricing strategies.

Market & Regulatory Analysis

• Monitor CMS and state Medicaid policy changes; assess their impact on product performance and strategy.
• Conduct competitive analysis and identify market opportunities to enhance plan differentiation and member value.

Performance Management

• Track and evaluate product performance including enrollment profitability and quality outcomes (e.g. STAR Ratings HEDIS CAHPS).
• Develop actionable recommendations to improve member experience retention and health outcomes.

Cross-Functional Leadership

• Serve as a subject matter expert for Duals strategy across the organization.
• Partner with compliance government affairs and operations teams to ensure successful execution of product initiatives.

Stakeholder Communication

• Present strategic insights and recommendations to senior leadership.
• Support product filings readiness reviews and ongoing regulatory reporting processes.
• Other duties and projects as assigned.

Qualifications what you need to perform the job

Certification and Licensure

Education

• Required (minimum): Bachelors degree
• Preferred: Masters in Public Health Business Administration or related field

Experience

• Required (minimum): 5-7 years in Medicare Advantage Medicaid managed care or healthcare product strategy.
• Preferred: 5-7 years of experience with D-SNPs or dual-eligible populations. Proven ability to interpret CMS and state Medicaid regulations.

Skill Requirements

• Strong analytical strategic thinking and problem-solving skills.
• Excellent communication and stakeholder management abilities.
• Proficiency in data analysis tools and Microsoft Office Suite.
• Experience in product filings or benefit configuration.
• Familiarity with quality improvement programs and value-based care models.
• Demonstrated success leading cross-functional healthcare projects

Working Conditions and Additional Requirements (include special requirements e.g. lifting travel):

• Must be able to work under normal office conditions and work from home as required.
• Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
• May be required to work additional hours beyond standard work schedule.

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.

Salary Range

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 comprehensive total rewards program colleagues are also eligible for variable pay. Eligibility for any bonus commission benefits or any other form of compensation andbenefits remains in the Companys sole discretion and maybe modified at the Companys sole discretion consistent with the law.

Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:

• Medical dental and vision coverage

• Retirement plans

• Paid time off

• Employer-paid life and disability insurance with additional buy-up coverage options

• Tuition program

• Well-being benefits

• Full suite of benefits to support career development individual & family health and financial health

For more details on our total rewards programs visit welcome all
All applicants are welcome and will receive consideration for employment without regard to race color religion gender gender identity or expression sexual orientation national origin genetics disability age or veteran status.

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