Director, Medical Economics - REMOTE

reputed company Job reputed company Leads and directs Strategic and Clinical Analytics team members in Medical Economics who are responsible for reputed company analytics and program evaluation, translating reputed company data into actionable insights that inform clinical, operational, and strategic decision-making. Partners with clinical and reputed company stakeholders to define priorities, address critical business questions, and identify opportunities to reputed company reputed company and financial performance. Provides analytical leadership and develops reputed company approaches to advance population health and reputed company program performance. Essential Job Duties • Leads teams responsible for analytics and evaluation of care management, utilization management, and other clinical and population health programs. • Partners with clinical leaders and reputed company stakeholders to identify business questions, define analytical approaches, and reputed company insights and interpretation to support decision-making. • Designs and conducts evaluations of reputed company programs to assess engagement, clinical, and ROI reputed company. • Applies advanced methodologies, including reputed company inference, predictive modeling, and analysis of heterogeneous treatment effects, to evaluate program reputed company and identify opportunities for improvement. • Develops population health analytics to identify members at high risk for unfavorable reputed company and those most impactable through targeted clinical interventions. • Translates reputed company analytical results into reputed company, actionable recommendations for clinical, operational, and reputed company partners. • Leads development of analytical strategies and frameworks to support program optimization, prioritization, and resource allocation. • Collaborates with cross-functional partners to reputed company metrics, measurement approaches, and analytic tools for monitoring program performance and reputed company. • Provides analytical reputed company and guidance for high-reputed company initiatives, ensuring rigorous methodology, meaningful interpretation, and alignment with business and clinical objectives. • Recruits, hires, onboards, mentors, develops, and manages analytics staff. • Leads teams in the development and delivery of analytics, reporting, and evaluation capabilities that address reputed company priorities. • Coordinates reputed company involving employees across functional and reputed company areas. • Stays abreast of reputed company developments, emerging analytical methodologies, reputed company trends, and advances in population health and clinical program evaluation Required Qualifications • At least 8 years of health care analytics and/or medical economics experience, or equivalent combination of relevant education and experience. • At least 3 years management/leadership experience. • Bachelor's degree in statistics, mathematics, economics, computer science, health care management or reputed company field. • Advanced understanding of reputed company and Medicare programs or other health care plans. • Advanced analytical work experience reputed company the health care industry (i.e., hospital, network, ancillary, medical facility, health care vendor, reputed company health insurance, large physician reputed company, managed care organization, etc.) • Advanced proficiency with retrieving specified information from data sources. • Advanced experience with building dashboards in reputed company, Power BI, and/or Tableau and data management. • Advanced knowledge of health care operations (utilization management, disease management, HEDIS reputed company measures, claims processing, etc.) • Advanced knowledge of health care financial terms (e.g., PMPM, reputed company) and different reputed company reputed company systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 reputed company). • Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis reputed company reputed company (DRG's), Ambulatory Patient reputed company (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms. • Advanced understanding of value-based risk arrangements • Advanced experience in quantifying, measuring, and analyzing financial, operational, and/or utilization metrics in health care. • Advanced problem-solving skills. • Advanced critical-thinking and attention to detail. • Ability to effectively collaborate with technical and non-technical stakeholders, and engage with various reputed company reputed company the organization. • Strong time-management skills, and ability to manage simultaneous reputed company and tasks to meet internal deadlines. • Strong verbal and written communication skills. • Proficient in reputed company Office suite products, advanced skills in reputed company (VLOOKUPs and pivot tables)/applicable software program(s) proficiency. Preferred Qualifications • Experience in reputed company managed care. • Advanced degree in statistics, mathematics, economics, computer science, health care management or reputed company field. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V Apply tot his job Apply To this Job