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Director, Medicaid ACO Strategy
Job Location:
Job Location:
Somerville, NJ - USA
Yearly Salary:
USD 124342 - 180898
Yearly Salary:
Posted:
16 September 2026 (11 hours ago)
Posted:
Application Deadline:
14 December 2026
Application Deadline:
Vacancies:
1 Vacancy
Vacancies:
Job Summary
Site: Mass General Brigham Health Plan Holding Company Inc.
Our work centers on creating an exceptional member experience a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds experiences and skills.
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 leads change efforts by working across the organization at all levels from direct reports to matrixed and cross-functional resources. 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 Plans 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.
Essential Functions:
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
oDemonstrate an articulate comprehensive vision and an understanding of the challenges and opportunities facing the ACO
oEnsure that the overall strategy is clear consistently evaluated and updated regularly
oAnalyze the external market environment and adapt strategies as appropriate
oPartner with medical economics clinical teams and MGB Population Health to develop strategies to manage medical trend
oDrive and influence Quality and Health Equity Performance to maximize member health outcomes and incentive payments from MassHealth
Oversee Medicaid product development to ensure a strategy and development plan; champion this development and coordinate the efforts of other senior executives where initiatives align
Monitor and evaluate financial performance metrics including medical cost trends risk adjustment and quality/health equity incentives
oPrepare 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.
Hold self and others accountable to meet commitments
Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise
Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization
Other duties as assigned with or without accommodationHybrid399 Revolution Drive40RegularDay (United States of America)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 Veterans Readjustment Act of 1974 and Title I of the Americans with Disabilities Act of 1990 applicants who require accommodation in the job application process may contact Human Resources at .
Mass General Brigham relies on a wide range of professionals including doctors nurses business people tech experts researchers and systems analysts to advance our mission. As a not-for-profit we support patient care research teaching and community service striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
Job Summary
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 worlds 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. Working with some of the most accomplished professionals in healthcare today our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds experiences and skills.
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 leads change efforts by working across the organization at all levels from direct reports to matrixed and cross-functional resources. 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 Plans 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.
Essential Functions:
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
oDemonstrate an articulate comprehensive vision and an understanding of the challenges and opportunities facing the ACO
oEnsure that the overall strategy is clear consistently evaluated and updated regularly
oAnalyze the external market environment and adapt strategies as appropriate
oPartner with medical economics clinical teams and MGB Population Health to develop strategies to manage medical trend
oDrive and influence Quality and Health Equity Performance to maximize member health outcomes and incentive payments from MassHealth
Oversee Medicaid product development to ensure a strategy and development plan; champion this development and coordinate the efforts of other senior executives where initiatives align
Monitor and evaluate financial performance metrics including medical cost trends risk adjustment and quality/health equity incentives
oPrepare 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.
Hold self and others accountable to meet commitments
Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise
Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization
Other duties as assigned with or without accommodation
Qualifications
Education
- Bachelors Degree required
Experience
- At least 8-10 years of Healthcare Business Development experience required
- At least 5-7 years of Medicaid/Medicare or Dual Eligible Program Management experience required
- At least 8-10 years of progressive management experience required
- Experience in Medicaid regulation policies and procedures highly preferred
Knowledge Skills and Abilities
- Proficient knowledge of government program policies (Medicare/Medicaid/Dual Eligible) requirements regulations and reimbursement models.
- Demonstrated understanding of value-based care accountable care organization models and population health management.
- Proven track record in strategic planning business development leadership and financial management.
- Excellent analytical negotiation and problem-solving skills.
- Exceptional communication and relationship-building abilities.
- Ability to collaborate effectively with various stakeholders and lead cross-functional teams.
- High level of strategic focus.
Additional Job Details (if applicable)
Working Conditions
- This is a hybrd role that requires in-person attendance to team meetings at least 1x/month
- 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
Work Location
Scheduled Weekly Hours
Employee Type
Work Shift
Pay Range
$124342.40 - $180897.60/AnnualGrade
9EEO Statement:
Mass General Brigham Competency Framework
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.
Required Experience:
Director
About Company
Patients at Mass General have access to a vast network of physicians, nearly all of whom are Harvard Medical School faculty and many of whom are leaders within their fields.
