Leads analytic functions in support of cost of care for MA and NY health plans:
Partner with Actuarial and Finance leaders to Identify key drivers of medical trend and loss ratio
Partner with market president, local chief medical officer, other national and local leadership to identify and drive activity in support of lowering medical cost, while optimizing quality; ensuring right treatment at the right time. This role provides critical analytical leadership in the team led by the market president.
Direct analytical support; engage in detail as needed, ensure optimal prioritization of analytical resources.
Ensure analytics are timely and accurate
Provide coaching for other medical economics analytical resources
Responsible for the direction and oversight of reporting and analytics. Develops and manages all critical reports and provides general analysis needed to support strategic decision making. Monitors critical metrics and informs leadership of potential risks. Works collaboratively with local health plan leadership, including: Market President, Chief Finance officer, Chief medical officer, clinical operations leader, Actuarial, and broader corporate resources such as IT. Fosters effective relationships with these colleagues; to become part of a team with shared goals for Health Plan. Ensures all resources are working up to their maximum potential to meet regulatory, customer and internal requirements, meeting all deadlines and following all of the proper policies and procedures. In addition, leads and possibly performs programming and analysis as needed. Requires working knowledge of all aspects and steps of data analysis. Directs the development of tactical and strategic plans to satisfy technical business needs. Leads standardization of data processes to ensure efficient practices that are best in class. Additional duties include providing guidance and mentoring to staff as required, and working with the business owners to set priorities of projects and associated tasks.
License and Certifications - Required
License and Certifications - Preferred
Other Job Requirements
Responsibilities Bachelors degree in Computer Science, Information Systems, or related field, or equivalent work experience. Demonstrated experience in computer systems and 10+ years experience in technical staff management. Strong development, management and communications skills (verbal and written); experience with systems development lifecycle methodologies (SDLC) and techniques; good project management skills. Excellent verbal and written communication skills; ability to create and lead staff in a team-oriented environment, extensive experience in working as a liaison between technical and non-technical groups; knowledgeable in the use and implementation of SDLC methodologies; proven ability to facilitate meetings. Minimum of seven years of systems analysis/development experience. Experience in the managed care, health care, or insurance industries a plus. Demonstrated experience in computer systems and 10 plus years experience in technical staff management.
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled
Associated topics: accounting, analyst, banking, cfa, cpa, financial controller, financial services, kpmg, pay, tax