Health Plan Strategy Lead

Abby Care•San Francisco, CA

2d•$150,000 - $200,000•Hybrid

About The Position

Abby Care is building the leading AI-native platform for family-led care. America is facing a growing care crisis, with millions of people needing care at home and over 50 million family caregivers supporting loved ones without adequate tools, training, or recognition. Abby Care believes families are the largest untapped caregiving workforce and that technology can empower them to deliver better care, driving stronger outcomes and greater transparency across the healthcare system. The company combines clinical oversight with an AI-powered platform to train, enable, and support family caregivers. Their platform assists health plans and government partners in understanding, verifying, and improving home care, thereby expanding access, reducing reliance on costly settings, and ensuring effective public spending. Abby Care partners with leading health plans, providers, and community organizations, backed by top VCs, and envisions a future where family-led care is integral to the healthcare system.

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.

Responsibilities

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, including opportunity sizing, competitive landscape mapping, and defining state-specific entry strategies.
Build a playbook for structured, repeatable market and vertical entry processes.
Identify and evaluate adjacent verticals and populations for Abby Care's model extension, building initial business cases and program parameters.
Research state-specific healthcare regulations, Medicaid waivers, licensing requirements, and payor mandates to ensure program and market designs are compliant.
Collaborate with Legal, Compliance, and Clinical leaders to finalize program parameters and hand off blueprints for operational execution.
Participate in strategic payor meetings, synthesizing feedback into program and market-entry adjustments.
Grow a team supporting research, modeling, and program design as the strategy function expands.
Set standards and processes for market research, economic modeling, and strategic recommendation packaging.