Director, Medical Economics - REMOTE

Job description

JOB DESCRIPTION: Job Summary: Leads and directs team responsible for medical economics analysis activities including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities and improve financial performance. Collaborates with health plans to identify and track savings opportunities. Drives trend performance review process to guide and influence decision-making related to clinical programs, initiatives, and strategy for Medicaid line of business and LTSS / Behavioral Health focus areas. Essential Job Duties: - Provides oversight for medical economics team and activities ensuring delivery of work/project plans, required reporting, development of savings tracking tools and performance/data management improvement initiatives. - Recruits, hires, onboards, mentors, develops, and manages Medical Economics staff. - Participates or leads standard trend management review with health plans/shared services to identify performance and trend mitigation opportunities. - Coordinates with shared services functions (payment integrity, national contracting, actuarial, etc.) to conduct quarterly deep dive trend reviews and opportunity analyses. - Coordinate...