The Director of Finance and Strategy, MassHealth Product will be the Finance program lead for the WellSense ACO and MCO programs under the Massachusetts Medicaid product known as MassHealth. WellSense’s MassHealth enrollment includes >500k lives across 8 different ACOs and 1 MCO throughout the commonwealth of Massachusetts. With this portfolio, WellSense is the largest health plan in the MassHealth program and our enrollment covers nearly 40% of MassHealth lives statewide. The MassHealth product is core to our health system mission of serving underserved populations across Massachusetts.
Under the direction of the Finance team at WellSense and in close partnership with the Population Health Services team at BMCHS, the Director will lead the finance arm of ACO performance and strategy. ACO performance measurement cuts across a number of key areas – medical expense management efforts (BH services, transitions of care services, and site of care optimization, to name a few), quality program performance, risk adjustment, and health equity. In designing and implementing strategy and programs against these performance levers, teams of clinicians, administrators, ACO provider partners, and others come together to collaboratively innovate and build programs that address the needs of our MassHealth members. The Director will be a key player in linking programs back to financial performance, scoping financial impact for new ventures and opportunities, measuring and reporting on progress and outcomes, and liaising and advocating with partners at the state on finance and program policy and design.
The role will oversee the people, processes, and systems that deliver timely and accurate reporting. In addition, this leader will be the face of the WellSense Finance Team with ACO partners – explaining performance, uncovering questions and opportunities, and helping ACOs leverage financial reporting and measurement to inform local strategies and program planning. The Director is responsible for the financial performance measurement and reporting for the MassHealth product, so the director must maintain a broad understanding of the MassHealth program design in order to identify and explain drivers of current financial performance and advocate for strategic program changes with the state or ACO partners to maximize results. This role requires comfort working in a matrixed environment, with significant interactions with the health plan executive team, external ACO executive staff and leaders at the state.
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