Principal Consultant, Medicaid Medical Economics & Cost Mgt.

Responsibilities

• Lead and track specific clinical, behavioral health, and Rx cost management initiatives across the Medicaid portfolio
• Develop and integrate a medical cost management plan into annual and multi-year business plans
• Act as the primary business partner to Finance, translating clinical insights into actionable financial impact
• Analyze historical and market data to recommend benchmarks and KPIs for pricing and reimbursement initiatives
• Research industry standards and develop new approaches to improve utilization and health outcomes
• Lead as business accountability champion for quarterly reviews with Trend Stewardship Committee
• Build strong relationships with key stakeholders to ensure engagement and consensus for initiative execution

Qualifications

• Bachelor's degree in Economics, Statistics, Public Health, Healthcare Administration, or related field
• 10+ years of healthcare industry experience (payer, medical economics, analytics, cost management, or related)
• Demonstrated experience leading cross-functional teams and executing complex, large-scale transformation initiatives
• Advanced analytic acumen; proficiency in Excel and data visualization tools
• Strong understanding of healthcare reimbursement models, managed care, and principles of medical cost management
• Pioneering organizational, planning, and prioritization skills
• Highly collaborative mindset, with excellent stakeholder engagement and executive-level communication skills

Benefits

• Medical, dental, and vision benefits
• 401(k) retirement savings plan
• Paid time off, including company and personal holidays
• Paid parental and caregiver leave
• Short-term and long-term disability insurance
• Life insurance