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Director, Individual Markets Engagement
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Director, Individual Markets Engagement & Operations Join to apply for the Director, Individual Markets Engagement & Operations role at Point32Health . Who We Are Point32Health is a leading not‑for‑profit health and well‑being organization dedicated to delivering high‑quality, affordable healthcare. We serve nearly 2 million members and build on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care guided by shared values. We are committed to inclusion and equal healthcare access for everyone regardless of background. We value the diverse backgrounds, perspectives, and experiences of all colleagues, which helps us serve communities with empathy and understanding. Job Summary The Director of Individual Markets Engagement and Operations is responsible for the overall success of Point32Health’s Individual Markets sales, products and operations, including both the Tufts Health Plan Direct products in MA, as well as the Harvard Pilgrim Health Care products in MA, ME and NH – a combined total of over 200,000 members. The Director is accountable for sales performance, broker engagement, distribution channels, member experience, and overall operations. The Director ensures identification of deliverables necessary to execute the strategy set by the LOB and coordinates with leaders across the organization to facilitate implementation, establishing a management structure that monitors performance of established targets and identifies key performance indicators to drive operational integration across the two logos in the MA market, ensuring best practices. Key Responsibilities / Duties Establish key performance objectives, monitor results, and coordinate data‑driven recommendations for both sales and operations. Accountable for individual market sales and meeting membership targets across three states and two logos through direct individual, federal and state‑based exchanges, and intermediary channels. Develop multi‑year growth strategy for membership and margin in partnership with ISG leadership, including all served states, population dynamics and distribution channels. Represent both logos with external stakeholders, including broker partners, intermediary channels and exchanges in all states; manage all processes related to these partnerships, including product portfolio input, marketing and vendor management, contract negotiations and execution. Ensure success of the sales team in assisting prospective individual members with plan choice and enrollment. Resolve escalated issues related to eligibility, payment and enrollment. Develop productive working relationships with a wide variety of external stakeholders, including brokers, regulators and advocates. Communicate individual market performance indicators and objectives clearly and effectively with all leaders across Point32Health for feedback and approval. Handle ongoing operations related to Federal and State Exchange participation, business process and compliance for newly released regulations, developing and maintaining policies in compliance with CMS regulations and ensuring policies are applied and compliant. Build a high‑functioning team of resources to support effective sales and operations. Conduct regular performance reviews and provide key developmental feedback. Effectively structure and delegate work to set the team up for success. Other duties and projects, as assigned. Education, Certification and Licensure Required: Bachelor’s degree in a related field. Preferred: Master’s degree (MPH, MBA, or other healthcare/financial focus). Experience (minimum years required) Required: 10–15 years of professional experience. Preferred: 10–15 years of health‑plan experience. Experience with group commercial and/or Affordable Care Act (ACA) health‑plan product management is strongly preferred. Skill Requirements Possess maturity and a high degree of professionalism. Exceptional oral and written communication skills for senior audiences. Knowledge of the sales lifecycle, exchange operations and individual consumers. Understanding of commercial health‑plan pricing strategies, including rating development and benefit design optimization. Strong understanding of individual insurance products, market dynamics and regulatory environment. Self‑starter, ability to think creatively, take responsibility and be resourceful. Enjoys and excels in executing in complex environments with significant uncertainty. Collaborative work across a highly matrixed organization, driving progress through influence. Proven ability to build relationships with external stakeholder groups, including regulators and advocates. Track record of developing and advancing junior team members and building high‑performing teams. Strong analytical skills, including financial management. Significant experience designing quantitative and qualitative data analyses and leveraging them for data‑driven decisions. Comfort working closely with internal and external clinicians. Strong project management and stakeholder management skills. Highly organized; able to delegate to team members and appropriately raise issues. Experience with software and database programs including Excel, Word, PowerPoint and AI‑powered software such as CoPilot. Working Conditions and Additional Requirements Must be able to work under normal office conditions and work from home as required. Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations. May be required to work additional hours beyond the standard work schedule. Salary Range $164,034.40 – $246,051.60 annually. Compensation & Total Rewards Overview The annual base salary range provided for this position represents a range of salaries for this role and similar roles across the organization. The actual salary will be determined by several factors, including role scope and complexity, skill, education, training, credentials, and experience, as well as internal equity. As part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains at the Company’s sole discretion and may be modified consistently with the law. Benefits Medical, dental and vision coverage Retirement plans Paid time off Employer‑paid life and disability insurance with additional buy‑up coverage options Tuition program Well‑being benefits Full suite of benefits to support career development, individual & family health, and financial health For more details on our total rewards programs, visit . We Welcome All All applicants are welcome and will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. Scam Alert Point32Health has recently become aware of job posting scams where unauthorized individuals posing as Point32Health recruiters have placed job advertisements and reached out to potential candidates. These individuals may ask the applicant to make a payment. Point32Health would never ask an applicant to make a payment related to a job application or job offer, or to pay for workplace equipment. If you have any concerns about the legitimacy of a job posting or recruiting contact, please contact Seniority Level Not Applicable Employment Type Full‑time Job Function & Industries General Business and Other – Insurance and Hospitals and Health Care #J-18808-Ljbffr
