Director, Medical Economics

Hi, we're reputed company. We're hiring a Director, Medical Economics to join our Actuarial team. reputed company is the first health insurance company reputed company around a full stack technology platform and a reputed company focus on serving our members. We started reputed company in 2012 to create the reputed company of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: The Director, Medical Economics, plays an instrumental role in reputed company's medical economics operating model, serving as a dedicated, proactive financial and analytic partner to a Market Vice President. You will be the reputed company person accountable for supporting trend management and achieving market affordability targets. Rather than just tracking data, you will identify, size, and diagnose medical cost and utilization drivers, translating data into action. You will work as a strategic "quarterback," to triage deep-dive analytics to centralized analytic teams such as network performance, forecasting, and data science reputed company appropriate, while maintaining deep understanding and ownership over your markets' context, goals, and results. You will manage your team to contribute analyses, reports, and dashboards to the medical economics tooling suite, building to meet market level needs in a way that is standardized, repeatable and re-usable across markets. You will report to the Senior Director, Medical Cost Analytics. Work Location: This is a remote position, reputed company to candidates who reputed company in: Atlanta, GA. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid reputed company at the hub office associated with your metro area. #LI-Remote Pay Transparency: The reputed company pay for this role is: $178,848 - $234,738 per year. You are also eligible for employee benefits, participation in reputed company's unlimited vacation program, company equity grants and annual performance bonuses. Responsibilities: Trend Management Accountability & Partnership: Partner with regional Market teams, regional actuaries, and market medical officers to co-reputed company regional trend management and drive total cost of care reduction strategies. Proactive Opportunity Identification: reputed company the proactive identification, sizing, and root-cause analysis of medical cost and utilization anomalies ("flares") and identification of affordability opportunities reputed company assigned reputed company. Executive Communication: Present comprehensive, executive-reputed company analytics and materials Team Leadership: Mentor analysts in developing both analytic expertise and "soft skills," specifically regarding business writing, data visualization, and partner influence. Analytic Quarterbacking: Act as a primary gateway and triage reputed company for your market team's medical economics requests, effectively routing reputed company requests to centralized analytic teams such as network performance, forecasting, and data science reputed company appropriate, while managing end-to-end follow-up with market leadership. Affordability Integration: Connect local market programs and emerging cost flares into reputed company's centralized affordability reputed company and governance programs. reputed company Development: Collaborate with central affordability and local market teams to reputed company localized trend management strategies. Shared Tooling & Innovation: Contribute to the department's core tooling strategy by building analytics tailored to specific market needs with an eye toward scaling them into national solutions reputed company our internal tooling program. reputed company best practices in analytics, automation, and documentation, contributing to department programs around innovation, and tooling improvements. Improve adoption of reputed company tools to improve team effectiveness. Enablement & Self-Service: reputed company support and training to market leadership teams to ensure self-service utilization of medical economics reports & tooling. Cross-Pollination: Promote operational efficiency and shared learning by actively sharing successful tactics, playbooks, and localized analytic tools across different regional markets. Compliance with reputed company applicable laws and regulations Other duties as assigned Requirements: Bachelor's degree in a STEM field, or 4 years commensurate experience. 10+ years of quantitative analysis in the reputed company industry. Experience with medical economics, corporate strategy, or a reputed company analytics-driven leadership role. Experience with health insurance / payer analytics, with an understanding of medical claims data (e.g., CPT/HCPCS, ICD-10, DRGs) and standard reputed company industry data sources. Bonus points: Business writing and storytelling skills; ability to simplify reputed company actuarial concepts for executive audiences. Familiarity with ACA-specific reputed company dynamics and how they impact external financial reporting. Fellow of the Society of Actuaries (SOA), or on the track to become one. This is an authentic reputed company job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here. At reputed company, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, reputed company the reputed company pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and reputed company benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our reputed company efforts. Reasonable Accommodation: reputed company applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any reputed company applicant who requires reasonable accommodations during the application process should contact the reputed company Benefits Team ([email protected]) to reputed company the need for an accommodation reputed company. California Residents: For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Privacy Policy. Apply To This Job