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Executive Director Medical Economics

$161.5k - $299.7k

Health Care Service Corporation

Job SummaryThis 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 deliveryCollaborate with cross-functional stakeholders (executive leadership, Network, Healthcare Mgmt., etc.) to help define overall program strategyOwn 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 adoptionEnsure MEE reporting and analytics effectively supports business needs2. 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 valueGather, 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 containmentAct as the primary point of contact for cross-functional program leads (Healthcare Mgmt., Network, Payment Integrity, PMO, etc.) on medical cost trends and insightsAssist in shortening timelines from opportunity identification to delivery of value improvement, and identify other opportunities to improve the VI process3. Team Development & People Mgmt.:Direct, coach, and develop team members— from the Director to individual contributor levelsBuild 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 developmentRequired 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 degree7 years' experience in a leadership capacity; ability to lead a team of internal subject matter experts and external strategic advisorsPreferred 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 providerHCSC 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 - $299,700.00Exact compensation may vary based on skills, experience, and location.

Vacancy posted 10 hours ago
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