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About the Role

Abby Care is seeking a Health Plan Strategy Lead to architect the strategy, economics, and regulatory foundation for growth. This role will be the primary architect behind new payor-facing care programs, focusing on research, design, and market strategy for new state markets, clinical verticals, and innovation opportunities. The ideal candidate is energized by tackling the unknown, charting new paths, and turning ambiguity into executable opportunities.

Responsibilities

Partner closely with the Head of Health Plan Strategy to define, structure, and document core design parameters, value propositions, and pilot architecture for home health payor initiatives.
Establish the quantitative foundation for programs by modeling program economics, setting target clinical and operational KPIs, and defining ROI frameworks.
Conduct deep market and operational research to guide strategic positioning, parameter design, and structural rollout.
Own the strategic business case for entering new state markets, sizing opportunity, mapping the competitive and payor landscape, and defining a state-specific entry strategy.
Build the playbook for market and vertical entry processes.
Identify and evaluate adjacent verticals and populations where Abby Care's care model can extend, and build the initial business case and program parameters.
Deeply research state-specific healthcare regulations, Medicaid waivers, licensing requirements, and payor mandates to ensure program and market designs are compliant.
Work with Legal, Compliance, and Clinical leaders to solidify program parameters and hand off finalized blueprints for execution.
Participate in strategic payor meetings, synthesizing payor priorities and feedback into actionable program and market-entry adjustments.
Grow a team supporting research, modeling, and program design as the strategy function's scope expands.
Set the standards and processes for market research, economic modeling, and strategic recommendation packaging.

Requirements

5+ years of professional experience in healthcare, with a strong preference for management consulting (healthcare practice), strategic payor innovation, or healthcare program design.
Deep understanding of healthcare payor landscapes, state Medicaid regulatory frameworks, home health models, and consumer-directed program structures.
Proven track record designing programs from scratch, including understanding regulatory/stakeholder needs, defining value proposition, establishing clinical and financial metrics, and evaluating pilot vs. full scale requirements.
Ability to combine quantitative and qualitative analyses and own the resulting business case.
Strong background in regulatory analysis and navigating state-by-state healthcare rules and compliance requirements.
Highly structured thinker who excels at crisp documentation, operational frameworks, and handoff packages for execution teams.
Experience managing or mentoring team members, or clear readiness to build and lead a team as scope expands.

Skills

Strategic architecture
Economic modeling
Regulatory analysis
Market strategy
Program design
KPI definition
ROI framework development
Market research
Business case development
Playbook creation
Quantitative analysis
Qualitative analysis
Healthcare regulations
Medicaid waivers
Licensing requirements
Payor mandates
Team leadership

Location

San Francisco

Work Type

Full-Time
4-days-a-week

Experience Level

5+ years of professional experience

Benefits

Competitive compensation packages
Comprehensive health coverage (medical, dental, vision)
PPO with $0 deductible
Company-funded HSA
Employer-paid life and disability insurance
Generous paid time off
10 paid company holidays
HSA contributions
Optional FSA
Commuter benefits
Full coverage of all 401(k) account fees
Up to 10 weeks of paid parental leave

About the Company

Abby Care is building the leading AI-native platform for family-led care, addressing the growing care crisis in America.
The company combines clinical oversight with an AI-powered platform to train, enable, and support family caregivers.
Abby Care's platform helps health plans and government partners understand, verify, and improve care in the home, expanding access and reducing reliance on higher-cost settings.
The company partners with leading health plans, providers, and community organizations and is backed by top VCs.
Abby Care envisions a future where family-led care is a core part of the healthcare system.

Equal Opportunity

Abby Care may use automated decision tools to help match and rank candidate work experience, education and skills found in online profiles, resumes and job applications against job requirements. We believe that these tools help ensure objective, data-based decisions during the hiring process, however, all Abby Care hiring decisions involve final human review and input. If you have questions or would like to request an alternative process, contact talent@abbycare.org.