Position: Manager, Medical EconomicsThe
Manager, Medical Economics is a key role focused on enhancing and executing a robust performance and trend analytics process at both the client and operational reporting levels. This position aims to identify medical cost trends and actionable opportunities that impact medical loss ratio (MLR), as well as to monitor performance against underwriting targets and operational metrics to identify gaps, recommend actions, and assess financial impacts. The role involves collaborating across various teams including Actuarial, Clinical, and Operations to implement and measure strategic actions based on analytical insights. This is an opportunity to shape analytics capabilities within a fast-growing, value-based care organization.
Responsibilities- Lead the analysis of medical cost trends and drivers, translating findings into clear, actionable recommendations that impact MLR performance
- Optimize the current MLR Trend Analytics toolset within an evolving enterprise data warehouse (EDW) framework, emphasizing organizational governance and efficient processes
- Collaborate cross-functionally with Clinical, Operations, and Actuarial teams to identify, prioritize, and measure initiatives that improve cost and quality outcomes
- Quantify financial impact of initiatives and track performance against underwriting targets and operational goals
- Develop and deliver clear, compelling presentations for senior leadership, simplifying complex analyses into business-relevant insights
- Support and lead ad hoc analyses in a fast-paced, evolving environment
Position Requirements- Bachelor's degree required; actuarial designation (ASA or FSA) a plus
- Minimum of five (5) years of relevant healthcare analytics, actuarial, or medical economics experience
- Advanced understanding of healthcare cost drivers, MLR, and value-based care models
- Experience building and presenting analyses using tools such as Excel and PowerPoint Proficient analytical and technical skills, including SQL and/or Python/R
- Proven ability to translate data into actionable insights and influence cross-functional stakeholders
- Demonstrated communication skills with experience presenting to leadership audiences
- Critical thinker, self-starter, and ability to prioritize and manage multiple initiatives at the same time
- Able to work in a fast paced and dynamic team environment
Benefits- Comprehensive Benefits - Medical, dental, and vision insurance, employee assistance program, employer-paid and voluntary life insurance, disability insurance, plus health and flexible spending accounts
- Financial & Retirement Support - Competitive compensation, 401k with employer match, and financial wellness resources
- Time Off & Leave - Paid holidays, flexible vacation time/PSSL, and paid parental leave
- Wellness & Growth - Work life assistance resources, physical wellness perks, mental health support, employee referral program, and BenefitHub for employee discounts
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