Health Care Service Corporation

Executive Director Medical Economics

Health Care Service Corporation$161K — $299K *
Healthcare
8 - 10 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor’s degree in finance, Actuarial Science, Healthcare Economics, or related field
  • 12 years of experience in healthcare analytics, or 10 years with an advanced degree
  • 7 years of leadership experience in a relevant capacity
  • Experience leading internal experts and external advisors
  • Preferred actuarial certification (FSA, etc.) or advanced degree (MBA, Master of Finance, etc.)

Responsibilities

  • Lead development of the Medical Economics Engine (MEE) by setting strategy and defining requirements
  • Collaborate with executive leadership to define overall MEE program strategy
  • Own business requirements for MEE and partner with data and IT teams
  • Ensure MEE reporting meets business needs
  • Serve as leader for the Value Improvement task force to analyze cost drivers
  • Present actionable insights on cost trends to inform decision-making
  • Direct and develop team members, fostering a collaborative environment

Benefits

  • Health and wellness benefits
  • 401(k) savings and pension plans
  • Paid time off and parental leave
  • Disability and supplemental life insurance
  • Employee assistance programs and paid holidays
  • Tuition reimbursement and other incentives
Full Job Description
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

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Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees.  Learn more about our benefit offerings by visiting .

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plansubject to the terms and the conditions of the plan.

Base Pay Range
$161,500.00 - $299,700.00

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

About Health Care Service Corporation

Health Care Service Corporation (HCSC) is the largest customer-owned health insurer in the United States. HCSC offers a wide variety of health insurance products and related services, through its operating divisions and subsidiaries in Illinois, Montana, New Mexico, Oklahoma and Texas. HCSC's headquarters is located in Chicago, Illinois.
Learn more about Health Care Service Corporation
Size
24,000 employees
Industry
Founded
1936

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