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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in healthcare landscape analysis, including Medicaid programs and payor operations, while effectively leading teams to design and implement strategic growth initiatives. Proficient in building financial models and conducting market research to support business case development and partnership success metrics.
Highest-signal resume keywords
Healthcare Landscape AnalysisMedicaid Program ResearchFinancial ModelingTeam LeadershipRegulatory Compliance
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Business Case DevelopmentMarket ResearchEconomic ModelingProgram DesignContract NegotiationPartnership Performance MonitoringSuccess Metrics DefinitionPilot DesignDocumentation SkillsOperational Framework Development
Soft Skills
Structured ThinkingTeam ManagementCross-Functional CollaborationCommunication SkillsProblem-Solving
Industry Keywords
Payor OperationsState Medicaid ProgramsRegulatory FrameworksHealth Plan EvaluationsValue Proposition DevelopmentStakeholder EngagementPartnership ManagementHealth Plan FluencyDuals and PACE MembersHybrid Work Environment
About the role
Key responsibilities & impact- Build business cases for entering new states by sizing opportunities and mapping competitive and health plan landscapes
- Conduct state Medicaid and waiver program research and assess implications for Abby Care’s business model
- Ensure program designs comply with state requirements and align with state incentive models
- Evaluate adjacent population verticals such as Duals and PACE members
- Set growth roadmaps for each state and determine health plans, value propositions, and leaders to approach
- Define Abby Care’s value proposition for each health plan based on priorities and economics
- Support contract negotiations and participate in health plan evaluations
- Join strategic health plan meetings and adjust programs and market-entry plans based on insights
- Structure pilots, including scope, success criteria, and path to scale
- Translate partner needs into clear requirements for product and engineering teams
- Build financial models showing Abby Care financial impact, volume and reimbursement targets, health plan value, and ROI
- Define clinical and operational partnership success metrics
- Monitor live partnership performance, identify drivers and gaps, and work cross-functionally on improvements
- Hire and lead a team across research, modeling, pilot design, and partnership performance
- Increase health plan fluency across clinical, operations, and product teams
- Create repeatable playbooks for market research, economic modeling, and executive and health plan recommendations
Requirements
What you’ll need- 5+ years of professional experience
- Strong preference for experience at a top-tier management consulting firm
- Deep understanding of the healthcare landscape, payor operations and economics, and state Medicaid programs and regulatory frameworks
- Experience researching state-by-state regulations, rules, and compliance requirements
- Experience or excitement designing programs from scratch, including regulatory and stakeholder needs, value propositions, clinical and financial metrics, pilot versus full-scale requirements, contract frameworks, and business cases
- Highly structured thinker with strong documentation, operational framework, and handoff package skills
- Ability to manage multiple active partnerships simultaneously
- Experience managing or mentoring team members, or clear readiness to build and lead a team
- Willingness and ability to work hybrid for this position
- Work authorization or sponsorship status for work in the United States must be addressed
Benefits
Comp & perks- Competitive compensation packages
- Medical, dental, and vision coverage, including a $0 deductible PPO
- Company-funded HSA
- Employer-paid life and disability insurance
- Paid time off
- 10 paid company holidays
- HSA contributions
- Optional FSA and commuter benefits
- Full coverage of all 401(k) account fees; employer match not currently offered
- Up to 10 weeks of paid parental leave based on tenure
- Equity