Executive Director Medical Economics

Responsibilities

• Medical Economics Engine (MEE) Development: Lead the development of our medical economics engine by setting program strategy, defining requirements for capability builds, and overseeing testing and delivery.
• Collaborate with cross-functional stakeholders (executive leadership, Network, Healthcare Mgmt., etc.) to help define overall program strategy.
• Own the business requirements and functional strategy for all components of the MEE platform, partnering with delivery (data, IT) teams to oversee feature prioritization, deployment, change mgmt., and user adoption.
• Ensure MEE reporting and analytics effectively supports business needs.
• Value Improvement (VI) Support: Serve as a core leader for the Value Improvement task force – helping to identify and analyze key cost drivers in healthcare services and ensuring actionable insights are derived to reduce costs and improve value.
• Gather, synthesize, and present timely and actionable insights on emerging trends, cost drivers, and outlier behaviors – enabling cross-functional leaders to make informed decisions on medical cost containment.
• Act as the primary point of contact for cross-functional program leads (Healthcare Mgmt., Network, Payment Integrity, PMO, etc.) on medical cost trends and insights.
• Assist in shortening timelines from opportunity identification to delivery of value improvement, and identify other opportunities to improve the VI process.

Requirements

• Bachelor’s degree in finance, Actuarial Science, Healthcare Economics, or related field.
• 12 years of experience in healthcare analytics, medical economics, or financial modeling analysis or 10 years of experience in healthcare analytics, medical economics, or financial modeling analysis with an advanced degree.
• 7 years’ experience in a leadership capacity; ability to lead a team of internal subject matter experts and external strategic advisors.

Qualifications

• Actuarial certification (FSA, etc.).
• MBA, Master of Finance, Master of Medical Economics, or similar advanced degree.
• SQL skills or equivalent querying tools experience.
• Analytics leadership experience with a health insurance payer or provider.

Benefits

Commensurate with experience.

Pay

$161,500.00 - $299,700.00 Exact compensation may vary based on skills, experience, and location.

Schedule

Hybrid role requiring in-office hours 3 days a week at the respective office location.