POSITION OVERVIEW
Harbor Health is looking for a VP of Benefit Plan Design & Strategy to lead the design of our health plan portfolio, both large group and ACA Individual/Family Marketplace products. This is a senior product leadership role reporting to our Chief Product Officer, and it sits right at the center of how Harbor Health turns our payvider model into plans members actually want to buy. You'll own plan design end to end: benefit structure, metal tier and actuarial value strategy, filing and compliance, and the creative thinking that makes our plans stand out in a crowded market. This is a builder's seat at a company still writing its own rulebook, so it takes real depth and real range.
POSITION DUTIES & RESPONSIBILITIES
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Lead the design and ongoing evolution of Harbor Health's large group and ACA Individual/Family Marketplace plan portfolios, from benefit structure through go-to-market.
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Partner closely with actuarial, network, and compliance teams to make sure plan designs are priced accurately, competitively positioned, and compliant with CMS and state DOI requirements.
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Own the ACA metal tier and actuarial value strategy, keeping plans compliant with essential health benefit requirements while finding ways to differentiate Harbor Health in the Marketplace.
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Drive the annual plan filing strategy, working across legal, compliance, and finance to hit state and federal deadlines.
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Bring genuinely creative, member-centered thinking to benefit design. Find ways to differentiate Harbor Health's plans beyond price.
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Build and present plan strategy and portfolio recommendations to executive leadership.
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Track competitor plan filings, market trends, and regulatory changes that affect plan design decisions.
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Mentor and develop team members as the plan design function grows.
DESIRED PROFESSIONAL SKILLS & EXPERIENCE
Required
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10+ years of experience in health plan product or plan design, with direct, hands-on experience designing large group commercial plans.
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Deep understanding of actuarial value calculations, metal tier structuring, essential health benefits, and CMS/state DOI filing requirements.
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Experience at a payer, payvider, or health plan, with a track record of plans that succeeded in the market, not just on paper.
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Strong cross-functional partnership skills. You'll work daily with actuarial, network, compliance, clinical, and finance leaders.
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A genuinely creative approach to plan design. This role needs someone who can look at a benefit structure and find an angle nobody else has tried.
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Bachelor's degree required; an advanced degree in health administration, actuarial science, or a related field is a plus.
Preferred
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Direct, hands-on experience designing and filing ACA Individual/Family Marketplace plans (preferred, not required).
WHAT WE OFFER
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Opportunity to shape how Harbor Health designs and brings health plans to market, both large group and ACA Individual/Family, from the ground up
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Collaborative and dynamic work environment
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An organization made of people who are passionate about changing the healthcare landscape
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Competitive salary and benefits package
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Professional development and growth opportunities
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A transparent and unique culture
COMPANY OVERVIEW
At Harbor Health, we're transforming healthcare in Texas through collaboration and innovation. We're seeking passionate individuals to help us create a member-centered experience that connects comprehensive care with a modern payment model. If you're ready to make a meaningful impact in a dynamic environment where your contributions are valued, please bring your talents to our team!
EQUAL EMPLOYMENT OPPORTUNITY
Harbor Health is an Equal Opportunity Employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other status protected by applicable federal, state, or local law. All employment decisions are based on qualifications, merit, and business need.
10+ years health plan product or plan design experience with large group commercial plans; deep understanding of actuarial value, metal tiers, EHB, CMS/state DOI filing; Bachelor's degree required; advanced degree preferred.
Key Responsibilities
- leading plan design
- partnering with teams
- mentoring team members
Job Details
- Category: Product Management
- Seniority: Senior Level
- Commitment: Full Time
- Workplace: Remote — United States
- Languages: English
About Harbor Health
A healthcare organization transforming care in Texas through collaboration and innovation. — Industry: Healthcare