Director of Medical Cost Strategy (Hybrid) - Homeward
Chicago, IL
About the Job
Homeward is rearchitecting the delivery of health and care in partnership with communities everywhere, starting in rural America. Today, 60 million Americans living in rural communities are facing a crisis of access to care. In the U.S. healthcare system, rural Americans experience significantly poorer clinical outcomes. This trend is rapidly accelerating as rural hospitals close and physician shortages increase, exacerbating health disparities. In fact, Americans living in rural communities suffer a mortality rate 23 percent higher than those in urban communities, in part because of the lack of access to quality care.
Our vision is care that enables everyone to achieve their best health. So, we're creating a new healthcare delivery model that is purpose-built for rural America and directly addresses the issues that have historically limited access and quality. Homeward supports Medicare-eligible beneficiaries by partnering with health plans, providers, and communities to align incentives – taking full financial accountability for clinical outcomes and the total cost of care across rural counties.
As a public benefit corporation and Certified B Corp™, Homeward's mission and business model are aligned to address the healthcare, economic, and demographic challenges that make it challenging for rural Americans to stay healthy. Our Homeward Navigation™ platform uses advanced analytics to connect members to the right care and local resources that address social determinants of health and improve holistic health outcomes. Since many rural communities lack adequate clinical capacity, Homeward also employs care teams that supplement local practices and reach people who cannot otherwise access care.
Homeward is co-founded by a leadership team that defined and delivered Livongo's products, and backed most recently by a $50 million series B co-led by Arch Ventures and Human Capital, with participation from General Catalyst for a total of $70 million in funding. With this leadership team and funding, Homeward is committed to bringing high-quality healthcare to rural communities in need.
The Opportunity
Join us in tackling healthcare for rural America! We're seeking a Director of Medical Cost Strategy, who is passionate about having a positive societal impact and using technology for good – solving issues of health inequity for communities that have been perennially underserved.
You'll be responsible for end-to-end Affordability Operations, ensuring that Homeward is best-in-class in developing, implementing, and improving scalable processes and operations to achieve utilization and cost management metrics across multiple markets. In addition to collaborating with centralized enablement functions to ensure success, you will partner closely with in-market teams to tailor solutions and incorporate on-the-ground feedback into our broader efforts to ensure our members and clients are reaping the benefits of this work. You will shape the direction of the company as the leader responsible for these critical outcomes.
What You'll Do
- Build the foundation and playbook that drives operational efficiency, process excellence, and performance improvement in Affordability interventions across multiple markets
- Partner with centralized functions such as Analytics & Data Science, Solutions & Technology, and Clinical Strategy to translate complex clinical challenges into operational solutions
- Partner with in-market teams to tailor and deploy solutions that are responsive to the local market dynamics and context, including solutions related to transitions of care, referral pathways, utilization management, high-value network development, and chronic condition management
- Lead implementation of external solutions that support the cost of care management, manage performance of those solutions, and drive evolution of our overall approach
- Leverage technology and operational efficiencies to drive scale across multiple markets
- Apply a deep understanding of the federal- and state-level regulatory landscape to position Homeward to deliver value in both the near- and longer-term
What You Bring
- 5+ years of hands-on affordability experience, including cost of care management, transitions of care, referral management, episodes of care, chronic condition management, pharmacy, behavioral health, and social determinants of health
- Demonstrated experience developing, implementing, and refining cost-of-care programs and operations within value-based care payment arrangements
- Superior track record of compliance leadership, including audit experience and expert knowledge of federal and state regulations
- Experience with provider engagement across internal, affiliated, and other types of provider partners
- Experience in scaling clinical operations across unique markets, with a focus on outcomes, efficiency, and compliance
Bonus Points:
- Experience in a high-growth, rapidly-scaling organization
- Experience with technology-enabled provider models
- Experience within a health plan cost of care management
- Experience with Medicaid, Medicaid, and/or ACA lines of business
- Experience addressing social determinants of health with impact and scale
What Shapes Our Company
- Deep commitment to one another, the people and communities we serve, and to care that enables everyone to achieve their best health
- Compassion and empathy
- Curiosity and an eagerness to listen
- Drive to deliver high-quality experiences, clinical care, and cost-effectiveness
- Strong focus on sustainability of our business and scalability of our services, to maximize our reach and impact
- Nurturing a diverse workforce with a wide range of backgrounds, experiences, and points of view
- Taking our mission and business seriously, but not taking ourselves too seriously– having fun as we build!
Benefits
- Competitive salary, equity grant
- Unlimited PTO
- Comprehensive benefits package including medical, dental & vision insurance with 100% of monthly premium covered for employees
- Company-sponsored 401k plan
- Flexible working arrangement
The base salary range for this position is $150,000 - $165,000 annually. Compensation may vary outside of this range depending on a number of factors, including a candidate's qualifications, skills, location, competencies and experience. Base pay is one part of the Total Package that is provided to compensate and recognize employees for their work at Homeward Health. This role is eligible for an annual bonus, stock options, as well as a comprehensive benefits package.
At Homeward, a diverse set of backgrounds and experiences enrich our teams and allow us to achieve above and beyond our goals. If you have yet to gain experience in the areas detailed above, we hope you will share your unique background with us in your application and how it can be additive to our teams.
Homeward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. Homeward is committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities.