Director of Market Management
Purpose
The Director of Market Management is responsible for the overall performance, sustainability, and strategic positioning of the local plans within an assigned geographic market. This role serves as the market “owner,” accountable for monitoring cost, quality, and utilization performance against budget and strategic targets, diagnosing variances, and developing actionable recommendations to improve results.
Essential Job Functions And Duties
Own and monitor market-level performance against budget, including medical cost, utilization, quality, and access (future metric: member experience) indicators ensuring alignment with budget and strategic goals.
Partner with analytics team to assess drivers of cost and performance variation (e.g., provider pricing, site of care, utilization patterns, network leakage, benefit design interaction).
Identify underperforming trends and develop clear, data-driven recommendations for action, including network, contracting, clinical, or operational interventions.
Partner with Finance, Clinical, Network, and Operations teams to evaluate financial impact, feasibility, and implementation pathways for recommended changes.
Support leadership and trustee discussions with fact-based analysis and strategic options and escalate risks through established governance forums.
Market Strategy and Development
Lead the development of a market-specific strategy that reflects local union, plan and employer needs and considers local healthcare dynamics, provider landscape, and regulatory environment.
Anticipate market-level healthcare cost trends and proactively recommend actions to mitigate risk or capture opportunity.
Identify opportunities to strengthen position through targeted partnerships, innovative contracting, care delivery alignment, or benefit strategy refinement.
Regulatory and Legislative Monitoring
Track and interpret state and local regulatory and legislative developments that may impact healthcare costs, provider behavior, or plan operations.
Translate developments into actionable insights and strategic implications for the market.
Collaborate with internal policy, legal, and compliance teams to ensure market strategies align with regulatory requirements and emerging mandates.
Provider, Partner and Coalition Engagement
Build and maintain relationships with key provider systems, community stakeholders, and external partners within the market.
Identify and participate in market coalitions or collaborative efforts that can influence provider behavior, pricing, quality transparency, or access.
Support or lead discussions that create collective market pressure for change, particularly in high-cost or highly consolidated markets.
Governance, Reporting and Decision Support
Develop concise, executive-level market performance summaries and strategic recommendations for senior leadership and trustees.
Establish clear success metrics and tracking mechanisms for market interventions and strategic initiatives.
Serve as the central point of accountability for market performance discussions, escalation, and decision-making support.
Essential Qualifications
Years of Experience and Knowledge: 8+ years of experience in healthcare strategy, health plan operations, network management, consulting, or market analytics.
Demonstrated expertise in healthcare cost drivers, provider contracting dynamics, and market-level performance analysis.
Experience navigating or assessing healthcare regulatory and legislative environments at the state or local level.
Experience working in high-cost, highly consolidated provider markets (e.g., major metropolitan areas).
Familiarity with Taft-Hartley or multi-employer health plan environments (preferred, not required).
Exposure to coalition-based purchasing, employer collaboratives, or value-based care initiatives.
Education, Licenses, and Certifications
Bachelor’s degree required; Master’s degree (MBA, MHA, MPH, or related) strongly preferred.
Skills And Abilities
Strong analytical skills with the ability to translate complex data into clear, actionable recommendations.
Executive-level communication skills with the ability to present to senior leadership or boards.
Proven ability to influence cross-functional stakeholders and external partners without direct authority.
Strategic mindset paired with operational discipline and follow-through.
Exceptional organizational, planning and prioritization skills with ability to manage competing deadlines and multiple projects in a fast-paced environment.
Nimble business mind with a focus on developing creative solutions.
Other Job Functions And Duties
Set goals and achieve measurable results.
Contributes ideas to plans and achieving department goals.
Exemplifies the Fund’s BETTER Values and professional effectiveness dimensions in contributing to a respectful, trusting, and engaged culture of diversity and inclusion.
Performs other duties as assigned within the scope of responsibilities and requirements of the job.
Pay
Salary range for this position: $153,600 ~ $195,900. Actual base salary may vary based upon, but not limited to: relevant experience, qualifications, expertise, certifications, licenses, education or equivalent work experience, time in role, peer and market data, prior performance, business sector, and geographic location.
Schedule
Work Schedule (may vary to meet business needs): Monday~Friday, 7.5 hours per day (37.5 hours per week).
Benefits
Medical, Dental, Vision
Paid Time-Off (PTO)
Paid Holidays
401(k)
Pension
Short- & Long-term Disability
Life, AD&D
Flexible Spending Accounts (healthcare & dependent care)
Commuter Transit
Tuition Assistance
Employee Assistance Program (EAP)