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Abby Care

Trains family caregivers for Medicaid reimbursement

Health Plan Partnerships Lead

Business Development & PartnershipsConfirmed live in the last 24 hours
Full-timeSan Francisco, CA, USA$150k - $200k /yr

About the Job

Requirements

  • At least 5 years of professional experience, with a strong preference for experience at a top-tier management consulting firm.
  • Deep understanding of the healthcare landscape, particularly payor operations and economics, state Medicaid programs and regulatory frameworks, and experience researching relevant regulations, state-by-state rules, and compliance requirements.
  • Experience or interest in designing programs from scratch, including understanding regulatory and stakeholder needs, defining value propositions, establishing clinical and financial metrics, evaluating requirements for pilot versus full-scale programs, combining quantitative and qualitative perspectives, and owning resulting contract frameworks and business cases.
  • Ability to produce clear documentation, operational frameworks, and handoff packages for execution teams, and to work across multiple active partnerships simultaneously.
  • Experience managing or mentoring team members, or clear readiness to build and lead a team as scope expands.

Responsibilities

  • Build business cases for new states by sizing opportunities, mapping competitive and health plan landscapes, and defining state-specific entry strategies.
  • Research state Medicaid programs, including waiver programs, health plan participation and priorities, and implications for the company’s business model; ensure program designs comply with requirements and align with state incentive models.
  • Evaluate adjacent populations, such as Duals and PACE members, and develop initial business cases and program parameters for those verticals.
  • Set the growth roadmap for each state by deciding which health plans to approach, the value proposition for each, and which leaders to engage.
  • Define the company’s offering and its relevance to each health plan, grounded in the plan’s priorities and economics.
  • Work with leadership on contract negotiations and participate in health plan evaluations of the company.
  • Attend strategic health plan meetings and translate insights into adjustments to programs and market-entry plans.
  • Structure pilots by defining scope, success criteria, and the path from pilot to scale for each new partner.
  • Represent health plan partners’ needs and translate them into clear requirements for the company’s product and engineering teams to achieve go-live readiness.
  • Build financial models for each partnership, including effects on company financials, required volume and reimbursement targets, and health plan value and return on investment.
  • Define the clinical and operational targets used to measure each partnership.
  • Monitor partnership performance, analyze drivers of outcomes and shortcomings, make results visible in the data, and work cross-functionally to address issues.
  • Build and lead a team across research, modeling, pilot design, and partnership performance as scope grows.
  • Increase health plan fluency across clinical, operations, and product teams.
  • Create repeatable playbooks for market research, economic modeling, and packaging recommendations for executive and health plan audiences.

Desired Qualifications

  • Experience at a top-tier management consulting firm.

About the Company

Abby Care

Trains family caregivers for Medicaid reimbursement

Abby Care provides home health services and a tech-enabled platform that trains and certifies family members to become paid caregivers (CNA/HHA) for relatives with disabilities on Medicaid. Families complete virtual, self-paced training at no cost, then become Abby Care W-2 employees who are paid weekly as they deliver in-home care documented via a mobile app. The platform includes care documentation, a caregiver community, and RN-supervised mentorship with data-driven care plans. The company aims to expand access to qualified in-home, family-based caregiving, leverage Medicaid reimbursement to reduce hospitalizations and institutional care costs, and grow across multiple states.

Company size
201-500
Company stage
Series C
Total funding
$117M
Headquarters
San Francisco, CA
Founded
2021

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