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Director of Medical Economics

  • Location:

    Pittsburgh

  • Sector:

    Aktuariat

  • Job type:

    Permanent

  • Salary:

    Up to US$210000 per annum

  • Contact:

    Tess Conly

  • Contact email:

    Tess.Conly@oliverjames.com

  • Job ref:

    JOB-022024-240039_1709852269

  • Published:

    etwa 19 Stunden her

  • Expiry date:

    2024-04-06

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



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