About the Organization:

Equality Health is an integrated, holistic, and tech-enabled healthcare delivery system focused on improving the health and wellness of diverse populations. Founded in 2015, Equality Health aims to improve access to value-based care for people who have long struggled with navigating the traditional one-size-fits-all U.S. healthcare system. The mission of the company is to provide high-quality care that improves and enhances lives regardless of race, ethnicity, age, or income.

Through its supplemental care management services and proprietary technology platform, CareEmpower�, Equality Health helps managed care plans and health systems improve outcomes and lower costs for diverse populations while simultaneously facilitating the transition to risk-based accountability. Equality Health supports over 800,000 members and more than 4,000 practice sites and continues to scale rapidly.

In 2021, Equality Health partnered with General Atlantic, a leading global growth equity firm, to help drive continued expansion and fuel the next phase of growth as a leading value-based primary care network serving the Medicaid, Medicare and ACA Exchange populations. This strategic investment will enable Equality Health to pursue further geographic expansion, technological innovation and product development while furthering its mission of increasing access to care, lowering costs and improving outcomes for underserved individuals, families and communities.

About the Role:

Equality Health is seeking a Head of Affordability to lead the company�s enterprise medical cost management and affordability strategy and execution in support of value-based care for Medicaid populations.

This role is responsible for identifying, sizing, prioritizing, and managing medical cost opportunities across Equality Health�s book of business, ensuring all interventions are grounded in evidence-based medicine, clinical best practices, and patient-centered care.

Key Responsibilities:

Medical Cost Opportunity Identification & Analytics

• Lead end-to-end identification and sizing of medical cost opportunities.

• Partner with Analytics, Actuary, and Finance on cost driver and utilization analysis at the contract, rate cell, and category of aid levels.

• Develop ongoing pipeline of interventions based on size and addressability of opportunities.

• Maintain a forward-looking view of emerging cost risks at both macro / industry level and micro / market / payor level.

Clinical Assessment & Addressability

• Partner with clinical and medical directors to assess clinical addressability of cost opportunities using evidence-based guidelines.

Prioritization & Intervention Strategy

• Develop and maintain a prioritized affordability roadmap.

• Evaluate opportunities based on size, speed, complexity, and channel.

Implementation & Cross-Functional Execution

• Lead execution of affordability initiatives across provider network, direct care, and vendor channels.

• Define plans, timelines, and success metrics for each intervention.

• Establish and manage relationships with vendors where utilized to deliver interventions.

Performance Measurement & Management

• Produce measurement framework for affordability initiatives and present monthly report during executive monthly operating review analyzing pipeline, execution, and any adjustments and / or investments required to achieve affordability targets.

Vendor Management

• Evaluate and manage external vendor partners engaged to deliver affordability interventions.

Leadership & Collaboration

• Demonstrate first-rate collaboration skills to marshal capabilities across the enterprise to deliver affordability targets.

• Demonstrate influence across functions you don�t control.

• Communicate effectively internally and externally to build support and demonstrate value delivered.

Required Skills & Qualifications:

• 10+ years healthcare analytics, medical cost management, or value-based care experience.

• Deep Medicaid and risk-based care experience.

• Strong analytical and clinical acumen.

• Demonstrated ability to set and achieve ambitious targets.

• Model Equality Health values and behaviors.

Equality Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.