Who We Are

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. To learn more about who we are at Point32Health, click here.

Job Summary

This Vice President, Medicare Stars Program is responsible for developing, leading, and overseeing execution of strategies, programs, and services to achieve and maintain 4+ Medicare Advantage plan star quality ratings in multiple states and contracts, and the highest levels of member satisfaction, retention, and overall member experience. The leader plans, facilitates, oversees, and collaborates with cross functional teams to develop, implement and monitor plans, as needed tailored to each market/contract. The leader is responsible for ensuring the necessary structure, process, resources and tools are in place and functioning effectively. This is a highly visible role, working with leaders across the organization and externally with provider quality leaders, including with joint venture partners. The leader will manage several program managers and analysts, and outreach staff.

Key Responsibilities/Duties – what you will be doing

Strategic Planning: Develop a strategic vision for health engagement initiatives, aligning them with organizational goals and priorities.
Program Development: Lead the design and implementation of innovative health and wellness programs that encompass physical, mental, and emotional well-being.
Employee Engagement: Foster a culture of health and wellness within the organization by engaging employees through workshops, seminars, challenges, and communication campaigns.
Community Outreach: Extend health engagement efforts to the broader community, collaborating with local organizations, schools, and healthcare providers to improve public health.
Data Analysis: Utilize data analytics to assess the impact of health engagement programs, making data-driven decisions to enhance program effectiveness.
Budget Management: Manage the budget allocated for health engagement programs, ensuring efficient allocation of resources and cost-effective solutions.
Vendor Relationships: Collaborate with external vendors, wellness providers, and healthcare partners to enhance the scope and quality of health engagement offerings.
Leadership: Lead and mentor a team of health engagement professionals, providing guidance and support to achieve program goals.
Compliance: Ensure that all health engagement initiatives comply with relevant laws, regulations, and industry standards.
Reporting: Prepare regular reports on the performance and outcomes of health engagement programs, presenting findings to senior management.
Other projects and duties as assigned.

Qualifications – what you need to perform the job

Background & Experience

Required (minimum): Bachelor’s degree
Preferred: Master’s degree
Required (minimum): 10-15 years in health care management/quality improvement
Preferred: Clinical background, experience with population health and quality improvement

Skill Requirements

Lead development of and oversee the execution of the Medicare member experience strategy, programs, and key initiatives.
Understand the drivers of member satisfaction, member engagement and retention and act to positively impact.
Lead the establishment of goals, objectives, and priorities to maintain/improve performance of star quality measures.
Utilize analytics to identify impactable member segments and collaborate with stakeholders to develop tailored interventions and communications.
Identify and manage innovative solutions to support improvement
Champion companywide awareness and understanding of the CMS Star rating to the overall success of the plan

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.

Disclaimer

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.

Leadership Profile

Establishing a Competitive and Compelling Vision: Orchestrates a competitive and compelling mission with an aligned set of values, goals, and a winning strategic path. This vision ensures a forward-looking aspirational framework that guides current and future decisions and choices for an entire enterprise or business unit.

Managing an Effective and Agile Plan Execution: Establishes, manages, and monitors the operational tactical annual plan to effectively accomplish the mission, vision, values, and strategy.

Creating and Cultivating Culture: Formulates, communicates, and lives the culture and tone of the organization through highlighting mission and strategy aligned citizenship behaviors, standards, and norms.

Optimizing Structure and Staffing: Attracts and selects staff and structures units, roles, and responsibilities; deploys aligned staff whose capabilities enable the organization to achieve its goals. Approaches decisions on talent utilization with both a tactical and strategic orientation.

Marshalling and Optimizing Resources: Obtains and distributes all the hard and soft resources aligned to priorities, goals, and strategy; deploys the resources that best enable the organization to do their work today and to prepare for tomorrow.

Monitoring and Appraising Results: Monitors and measures progress against plan; provides real time supportive and corrective feedback and assistance.

Representing and Responding to Stakeholders: Prepares and delivers presentations to and managers productive relationships with critical stakeholders; recognizes and responds to the diverse needs of key inside and outside stakeholders.

Intervening In and Managing Conflict: Monitors and referees the normal and inevitable individual, team, and business unit conflicts; offers assistance and direction that moves to productive resolution. Utilizes productive conflict as a source of creativity, enhanced trust, and effective interpersonal problem solving.

Investing In and Assuring Future Leadership: Actively supports a vigorous talent management and succession process that provides a continuous flow of senior talent well into the future.

Senior-Level Clinical Leadership in Related Industry Experience: Experience in financial roles of increasing scope and responsibility; credibility earned from having served at least 20 years in executive finance positions in publicly traded or not-for-profit health organizations. Significant experience interacting with the board of directors and its audit committee and managing the organization’s relationship with banks and outside auditors.

Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity

Point32Health is committed to making diversity, equity, inclusion, accessibility and health equity part of everything we do—from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity team's strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who 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.

Compensation & Total Rewards Overview

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 and benefits remains in the Company's sole discretion and may be modified at the Company’s 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 https://www.point32health.org/careers/benefits/

Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity

Scam Alert: Point32Health has recently become aware of job posting scams where unauthorized individuals posing as Point32Health recruiters have placed job advertisements and reached out to potential candidates. These advertisements or individuals may ask the applicant to make a payment. Point32Health would never ask an applicant to make a payment related to a job application or job offer, or to pay for workplace equipment. If you have any concerns about the legitimacy of a job posting or recruiting contact, you may contact TA_operations@point32health.org