Executive Director Medical Economics

Job Summary

This position is responsible for leading enterprise-wide medical economics strategy to improve the way we analyze medical cost, and how we surface insights to cross-functional stakeholders to help design initiatives to improve medical value. It is the business owner for our Medical Economics Engine (MEE), creating program strategy, defining requirements for capability builds, collaborating with cross-functional executive leaders to provide actionable insights. This is a hybrid role and requires in-office hours 3 days a week at the respective office location. Responsibilities include:

1. 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

2. 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

3. Team Development & People Mgmt.:

• Direct, coach, and develop team members from the Director to individual contributor levels
• Build the team to support development of additional capabilities (program strategy, AI-enabled insights, etc.)
• Foster a collaborative team environment, set goals, monitor performance, and support professional development

Required Job Qualifications:

• 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

Preferred Job 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

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range

$161,500.00 - $299,700.00

Exact compensation may vary based on skills, experience, and location.