Jobs at Point32Health

Provides MassHealth and Medicare eligibility guidance and enrollment assistance to seniors, adults with disabilities, caregivers, and members. Conducts outreach, presentations, referrals, application and renewal support, documentation follow-up, and lead generation for SCO and One Care programs. Maintains CRM records, tracks applications through MMIS or the MassHealth Enrollment Center, supports redeterminations, meets enrollment goals, and coordinates with internal teams and community partners while serving diverse populations.

Leads the Cyber & Information Security portfolio and program governance for a healthcare organization. Oversees prioritization, dependencies, risks, budgeting, execution, reporting, process optimization, and executive visibility across security initiatives. Supports CISO and Board engagements, coordinates governance materials and follow-up, participates in business continuity exercises, advises leadership on operational risks, and mentors team members. Requires substantial experience managing complex technology or security programs in regulated environments.

Manage and support cross-functional program operations and vendor relationships. Perform policy and impact analyses, recommend process changes, support planning and implementation of projects, facilitate meetings, track deliverables, and resolve roadblocks to ensure program success.

Lead enterprise underwriting and pricing strategy for large and small group business. Develop rates, underwriting policies, tools, and stop-loss management; direct underwriting operations, analytics, vendor and sales support, and team leadership to balance market penetration and profitability while ensuring regulatory compliance.

Provide strategic leadership for provider partnership and network strategy, aligning contracting, product, clinical, operational, and finance goals. Oversee network, cost, and utilization analytics; design value-based payment and partnership models; grow and optimize networks for adequacy and regulatory alignment; monitor market and policy trends; drive execution of initiatives and sponsor governance, while leading and coaching director-level teams to deliver measurable results.

Lead month-end and quarter-end close for multiple health plans; manage accounting staff; prepare GAAP and NAIC statutory financials and tax filings; coordinate external audits; develop technical accounting policy and internal controls; support regulatory compliance and special financial reporting projects.

The Lead Financial Planning Analyst supports expense management, budgeting, financial analysis, and reporting for various operational areas, ensuring effective cost control and strategic recommendations.

Lead delivery of complex, high-risk Individual and Small Group product programs. Define portfolio strategy and roadmap, manage cross-functional teams and vendors, oversee P&L and financials, ensure operational readiness, and coach product managers to launch and evolve products across regional markets.

The Director of Network and Provider Analytics oversees analytics for provider contracts and network performance, leads teams, and collaborates with various departments to improve healthcare delivery and operational effectiveness.

The Procurement Category Manager manages vendor relationships, contract negotiations, and performance measurements across indirect categories, ensuring optimal value and risk management.

Lead multi-year product strategy and roadmaps for health insurance product lines. Drive product design, enhancements, and discontinuations; lead cross-functional teams; incorporate stakeholder feedback; perform financial modeling and competitive analysis; monitor portfolio performance and recommend course corrections; collaborate on marketing and customer experience; manage vendors and ensure regulatory compliance to meet membership and profitability goals.

The Senior Business Data Analyst handles complex data analyses, collaborates with stakeholders, documents technical specifications, and develops data solutions to meet business objectives, ensuring quality and compliance.

As Vice President of Affordability, you will lead the enterprise strategy to reduce the Total Cost of Care, influence senior executives, and collaborate across departments to improve healthcare affordability and performance.

Lead multiyear network product strategy and cross-functional teams to design, launch, and optimize health insurance network products. Drive compliance with state and federal regulations, financial modeling, portfolio performance monitoring, stakeholder engagement, vendor management, and go-to-market collateral and training to meet membership, profitability, and operational goals.

The Senior IT Internal Auditor evaluates internal controls, assists with audits, prepares audit workpapers, and ensures completion of management action plans.

Provide administrative and project support to faculty and team: manage calendars and CVs, draft communications and slide decks, arrange travel, track expenses and purchase orders, assist with grant submissions (budgets, biosketches), coordinate virtual and in-person meetings and events, and support special projects as assigned.

Analyze, track, and summarize federal legislation and regulations affecting the organization; develop policy positions, support Federal Affairs leadership, provide technical guidance to business units, and engage stakeholders to advance organizational priorities.

Lead design, development, and implementation of advanced ML and NLP models for payment integrity. Translate business problems into analytics, run large-scale experiments, automate analyses, validate and operationalize models, and present actionable insights. Manage multiple projects, mentor junior staff, and enforce governance, ethical norms, and scalable processes to improve quality, member experience, and cost outcomes.

Provide break/fix and endpoint support for desktops, laptops, printers, mobile devices, and telephony. Diagnose incidents in the ITSM, image/configure devices, manage asset lifecycle, perform installations/upgrades, and deliver end-user training and onsite support.

Manage complex compliance programs and regulatory projects for a health insurer, including regulatory audits, risk assessments, policy recommendations, cross-functional implementation, reporting, and vendor oversight. Lead planning, facilitate stakeholder negotiations, and support ongoing compliance monitoring, education, and remediation efforts to ensure adherence to Medicare, Medicaid, and commercial regulations.