Manager, Medical Economics

Manager of Medical Economics.  In this role, you will actively lead and participate with a team to create and implement sophisticated analytics, and provide support for strategic and business decision-making. You will work collaboratively with stakeholders from across the organization to provide information, insights and BI (Business Intelligence) solutions that contribute to sound strategic planning, decision-making, goal setting, and effective performance measurement.

As part of your responsibilities, you will:

Help identify and understand data from internal and external sources for competitive, scenario and performance analyses, and financial modeling to gain member/provider insight into new and existing processes and business opportunities.

Act as liaison/analyst manager for internal stakeholders, understand their needs and translate them into reporting and analytic solutions.  Also help staff become more efficient and effective at gathering requirements.

Will work on and lead projects focused on utilization management trends where you’ll help find insights in the data and work with clinical and administrative stakeholders to identify opportunities to improve and ultimately measure their effectiveness.

Will work on and lead projects focused on care management, disease management and quality management optimization, working with stakeholders to identify and execute opportunities for improvement.

Effectively communicate with your stakeholders and customers and ensure all requests are properly triaged, recorded and tracked.  Also help staff demonstrate emotional intelligence when communicating with others.

Analyze issues using enrollment, utilization, clinical, medical management, financial and other corporate data, and information from both modeled internal data as well as disparate internal and external sources.  Also help staff develop better analysis skills, understanding use cases and their value to the organization.

1. Work with departmental staff to identify requirements for reporting and / or business intelligence tools.
2. Identify necessary data, data sources and methodologies.
3. Collect, organize, integrate, analyze and interpret data.
4. Leverage advanced statistical analysis methods to create insightful recommendations and conclusions that you effectively communicate to your stakeholders.
5. Identify and address expected and unforeseen data complexities to mitigate their impact on the analytic outcome and associated business decisions. Clearly communicate data issues to the recipients and work to improve data quality where possible within the analytical models you create.  Feed data quality issues back to IT or identified data stewards to assist in our quest for high quality data.
6. Develop and present reports, analyses and findings to senior management and others as scheduled or requested.

Adhere to corporate standards for performance metrics, data collection, data integrity, query design, and reporting format to ensure high quality, meaningful analytic output.

Work closely with IT on the ongoing improvement of Mount Client’s integrated data warehouse, driven by strategic and business needs, and designed to ensure data and reporting consistency throughout the organization.

Develop and maintain project work plans, including critical tasks, milestones, timelines, interdependencies and contingencies.  Track and report progress.  Keep stakeholders apprised of project status and implications for completion.  Also guide staff to better time and project manage.

Provide technical support to data analytics functions as they relate to varied business units, and technical expertise on the selection, development and implementation of various reporting and BI tools tied to business unit reporting requirements. Create new BI reports and interactive dashboards as required.

Prepare clear, well-organized project-specific documentation, including, at a minimum, analytic methods used, key decision points and caveats, with sufficient detail to support comprehension and replication.  Delegating or providing direction and feedback to staff when appropriate.

Ensure customers are adequately trained to use self-service BI tools and dashboards.

Assist and teach others within the organization on how to a) define meaningful process and performance measures, b) develop BI queries, and c) generate and use management reports effectively.

Share development and process knowledge with analysts in order to assure consistency and continuously build a core of analytical strength within the organization.

Demonstrate proficiency with the principles and methodologies of process improvement.  Apply these in the execution of responsibilities in support of a process focused approach.

Requirements for this position include:

• Minimum of BA/BS degree in a relevant field of study; Masters degree preferred.
• At least three (3) years of leadership experience at a director, manager or equivalent level, leading an medical economics, actuarial informatics, analytics, data warehousing or BI team.
• At least seven (7) years of medical economics, actuarial informatics, analytics or highly impactful reporting development experience for a health provider, plan or managed care organization including either:
  • Experience working in health plan actuarial, financial reporting or medical economics departments.
  • Working knowledge of health care EMR or claims systems such as Epic/Clarity, eCW, Facets, QNXT, Amisys, or similar systems.
  • Knowledge of New York State Medicaid and CMS Medicare regulations and related reporting requirements such as STARS, QARR, MMCOR, MEDS, RAPS, EDGE and HEDIS.
  • Experience working in healthcare provider analytics related to revenue modeling, managed care contracting, population management, case management, clinical or financial decision support,
  • PhD, MD or DO program may be substituted for 3 years of experience
• Must have strong analytical skills, with the ability to perform complex analysis and make recommendations based on statistical inferences. Experience with and an understanding of a wide variety of analytical or statistical methods.
• May have a strong working knowledge of Business Intelligence products such as Tableau, Information Builders, Dimensional Insights, SAP/Business Objects, SAS, MicroStrategy, etc.
• May have a strong working knowledge of scripting or data mining tools like SQL, R, Python, SAS, Java/MapReduce, Aster, etc
• Should have a general understanding of the purpose of ETL tools like SSIS, Data Stage, PowerCenter, etc.
• Demonstrated ability to exercise critical thinking and logical reasoning, and understand the conceptual framework and database relationships underlying health care data.
• Demonstrated ability to think creatively; demonstrated excellent problem solving skills.
• Excellent oral and writing skills characterized by the ability to communicate effectively with varying audiences.
• Demonstrated ability to articulate goals, plan and implement processes to achieve those goals, recognize and assess the implications of confounding variables, anticipate consequences, and meet deadlines.
• Advanced interpersonal (e.g., mediating, mentoring, teaching) skills required to service internal and external clients effectively, and manage relationships and activities that are diverse and complex.
• Self-motivated and resourceful, with a demonstrated ability to think and work independently, and to exercise independent judgment in originating or developing complex techniques or programs in a complex and dynamic environment.
• High level of integrity as demonstrated by 1) appropriate treatment of confidential information, 2) adherence to policies, procedures, rules, and regulations, 3) professional conduct in dealing with persons internal and external to the organization, and 4) sensitivity to populations served by the organization.

Permanent opportunity... Please only apply if at least 75% of qualifications are met