About Commonwealth Care Alliance
Based in Boston, Commonwealth Care Alliance (CCA) is a not-for-profit, integrated care system influencing innovative models of complex care nationwide. Mission-based and person-centered, CCA is singularly focused on sustainable and evidence-based healthcare breakthroughs that fill important gaps in care and improve the health and well-being of people with significant needs. This includes advocating for affordable, high-quality, and cost-effective healthcare policies that lead to healthcare equity for individuals who need it most.
CCA’s unique model of uncommon care has achieved an unparalleled track record of improved health and quality outcomes and lower costs of care. In 2021, CCA began a multi-year, mission-aligned geographic diversification growth strategy to extend its proven care model throughout the United States. With its newly launched health plans in Massachusetts and Rhode Island and recent acquisitions in California and Michigan, CCA serves nearly 62,000 individuals across four states.
Why This Role is Important to Us
The Medicare Policy and Federal Affairs Director develops CCA’s Medicare Advantage policy strategy and elevates CCA’s related Medicare-focused national thought leadership. The Director helps to drive CCA’s position and influence external policymakers to advance policy that better recognizes and meets the needs of Medicare beneficiaries with significant needs.
What We’re Looking For
Education:
Required: Bachelor of Science or Arts degree with an emphasis in public policy; public, health or business administration; or related field.
Experience:
• 10 + years
• Strong understanding of the federal rulemaking process
• Strong understanding of the Medicare Advantage and Part D programs
• Strong understanding of federal payment policies
• Experience with public health policy for a health care insurer and/or provider-based organization with a focus on Medicare and complex populations
What You’ll Be Doing
Primary Duties: Medicare Policy Development
• Serves as CCA’s Medicare and Medicare Advantage policy subject matter expert.
• Works with teams across CCA to analyze and develop suggestions for or respond to new Medicare opportunities released by the Center for Medicare and Medicaid Services (CMS).
• Supports design and implementation of CCA’s Medicare Policy strategy that promotes CCA’s objectives through compelling engagement in government and public arenas.
• Directs responses to federal RFIs, and CMS’ Medicare Advantage or other Medicare proposed rules. Depending on the topic and level of technicality, this may include drafting responses, interviewing and/or collecting information from other CCA subject matter experts.
• Creates internal and external materials to support CCA’s business development activities in Medicare markets to help educate stakeholders and drive key CCA policy positions.
• Serves as primary contact for Medicare health plan association work, MedPAC, and other national Medicare policy and advocacy organizations that are aligned with CCA’s mission.
• Supports or drives development of new policy ideas to improve quality of, access to and cost-effectiveness of Medicare Advantage for Medicare beneficiaries with significant needs.
• Develops policy papers to advance the Medicare policy and regulatory agendas of CCA.
• Potentially supervises manager, analyst or intern-level staff as CCA’s Medicare capabilities expand.
Primary Duties: Federal Affairs
• Represents CCA in Medicare discussions with Capitol Hill and CMS.
• Supports Government Relations leadership in enhancing or facilitating communications about our unique Medicare model in different markets.
• Directs the evaluation of pending Medicare legislation and regulations that may impact CCA and develops timely recommendations for senior management and key business leaders.
Secondary Duties & Responsibilities
• Works closely with Vice Presidents of Policy Development and Government Relations in the development, implementation and facilitation of CCA’s Medicare market strategy.
• Works closely with Compliance team to ensure staff are educated about proposed Medicare policies and CCA’s related positions and commenting opportunities. Supports the Compliance team’s work to educate other teams about final versions of new Medicare policies.
• Serve as Medicare Policy and Federal Affairs liaison to other internal departments (e.g., clinical, operations, business development, business intelligence, etc.) to ensure that they are using updated Medicare policy information to inform operational strategy and:
o Provide guidance and assistance as requested;
o Attend ad hoc meetings with department leadership, other CCA subject matter experts or other teams as requested; and
o Support business units in interpretation of proposed or new policies related to their applicable areas as well as provide assistance in developing appropriate tools to ensure understanding of the impact.
o May supervise Policy or Government Relations analyst staff
Actual Work Location
Remote, Boston, Massachusetts 02108
All Locations
REMOTE
Exempt / Not Exempt
Exempt
