Job Description - Director Medical Economics - remote
Responsibilities:
- Partner with Health Plan senior leadership for creative problem-solving and strategic decision-making involving medical cost improvement strategies.
- Lead the development of detailed actuarial and financial models that communicate near and long-term projections of financial performance of new and ongoing initiatives and clinical programs to facilitate corporate decision-making and the development of strategies and goals.
- Forecast and interpret financial results, including variances from budget, to help identify medical cost improvement opportunities and potential risks.
- Develop and gain support for data-based recommendations with team members from product, clinical, network, and strategy functions.
- Bring clarity to complex problems using exceptional communication skills when engaging with senior leadership and technical audiences.
- Apply an understanding of complex actuarial concepts, methods, and applications in a variety of situations.
- Creatively leverage a wide range of datasets to inform key analyses.
Qualifications:
- ASA or FSA
- Experience in the following is a strong preference:
- Value-based reimbursement, population health, segmentation/ stratification, claims development etc.
- 8+ years of health actuarial experience, preferrably in the cost analysis and medical economics spaces
- Management experience required of 3-4 individuals
Director of Medical Economics
Insurance Industry
Our client in the Insurance industry is seeking a Director of Medical Economics to join their Actuarial department.
Role & Responsibilities:
- Develop and implement strategies for analyzing and managing health insurance medical economics
- Provide leadership in the development of pricing models and risk assessment tools
- Collaborate with cross-functional teams to drive business decisions based on data-driven insights
- Stay updated on industry trends and regulatory changes to ensure compliance and optimize performance
Key Skills:
- In-depth knowledge of health insurance and medical economics
- Strong analytical and problem-solving skills
- Experience in developing pricing models and risk assessment tools
- Ability to communicate complex concepts effectively to stakeholders at all levels
- Excellent leadership and organizational skills
