Director, Healthcare Economics

 The Director, Healthcare Economics drives organizational financial performance, designing data analyses and reporting to identify cost savings opportunities, collaborating across the company to support implementation of new interventions, and constructing financial models to assess the success of those interventions.

To be successful in this role, you:

• Possess a bachelor’s degree in healthcare management, business administration, or a closely related field, and/or experience in this area.
• Have 5 years people management and leadership experience across financial and/or data functions.
• Have 7 years of analytical experience leveraging data, designing reports, and generating actionable insights to identify cost savings opportunities.
• Have 7 years of experience building collaborative relationships, managing cross-functional initiatives in a healthcare setting, and demonstrating the ability to support and influence collaborators.
• Have 7 years of experience constructing financial projection models and monitoring ROI of initiatives.
• Have excellent communication and interpersonal skills.
• Have experience presenting to senior leadership, cross functional teams, providers, and vendors.
• Are experienced in using Microsoft Office applications such as Outlook, PowerPoint, Word, Excel.

Essential functions and Roles and Responsibilities:

• Please list the essential functions and roles and responsibilities
• Provide leadership and vision across CHPW in the pursuit of cost savings and opportunity identification through market research, networking and conference/webinar attendance.
• Provide leadership, coaching, and development to team members, ensuring a high-performing and engaged team.
• Review line of business performance monthly reporting package (MRP) for the purpose of identifying aberrations in utilization and unit cost trends, service mix, facility mix, and other factors.
• Design and request enhancements to MRP and other reporting assets, as needed.
• Collaborate with finance colleagues to validate and reconcile MRP and other reporting assets to financial statement data on an annual basis.
• Meet monthly with Contracting, Clinical Services and Operations departments to share insights and findings in a manner that is easy for colleagues to interpret the data, identify opportunities and risks, and consider new interventions to address those opportunities and risks.
• Identify and package provider-level analyses and opportunities identified for Clinical Partnerships team to deliver to targeted providers’ leadership teams. Assist Clinical Partnerships team with understanding the data, preparing for meetings, and presenting to providers’ leadership team. Field follow-up questions from providers’ leadership teams.
• Lead one or more analysts and direct matrixed analysts to conduct ad hoc analyses in support of colleagues’ needs for additional information to vet potential cost saving opportunities.
• Once opportunities have been vetted and planned for implementation, design and build cost models to track progress and assess ROI.
• Partner with program management staff to track progress against annual savings targets, assist in creating solutions to overcome barriers, and communicate status and success to senior leadership.
• Play a central role in redesigning internal and external facing business intelligence tools for future deployment.
• Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion.

Knowledge, Skills, and Abilities:

• Knowledge of healthcare delivery and health plan management in terms of claims payment methods, claims coding, provider organization structure, network design, provider contracting models, stakeholder concerns, utilization management practices, regulatory requirements, data warehouse structure, and financial concepts (e.g., risk adjustment).
• Knowledge of project management methodologies, and skilled at managing projects from inception to completion.
• Ability to set performance expectations, coach for performance success, and achieve department and company objectives.
• Ability to organize, manage, and prioritize work to meet deadlines and maintain organized program tracking.
• Ability to analyze data, generate reports, and translate insights into actionable strategies.

As part of our hiring process, the following criteria must be met:

• Complete and successfully pass a criminal background check.

Criminal History: includes review of criminal convictions and probation. CHPW does not automatically or categorically exclude persons with a criminal background from employment. The applicant’s criminal history will be reviewed on a case-by-case basis considering the risk to the business, members, and/employees.

• Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency.
• Vaccination requirement (CHPW offers a process for medical or religious exemptions)
• Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation.

Compensation and Benefits:

The position is FLSA Exempt and is not eligible for overtime. Based on market data, this position grade is 72 and has a 15% annual incentive target based on company, department, and individual performance goals.

CHPW offers the following benefits for Full and Part-time employees and their dependents:

•  Medical, Prescription, Dental, and Vision
•  Telehealth app
•  Flexible Spending Accounts, Health Savings Accounts
•  Basic Life AD&D, Short and Long-Term Disability
•  Voluntary Life, Critical Care, and Long-Term Care Insurance
•  401(k) Retirement and generous employer match
•  Employee Assistance Program and Mental Fitness app
•  Financial Coaching, Identity Theft Protection
•  Time off including PTO accrual starting at 17 days per year.
•  40 hours Community Service volunteer time
•  10 standard holidays, 2 floating holidays
•  Compassion time off, jury duty pay.

Sensory/Physical/Mental Requirements:

Sensory*:

• Speaking, hearing, near vision, far vision, depth perception, peripheral vision, touch, smell, and balance.

Physical*:

• Extended periods of sitting, computer use, talking and possibly standing.
• Simple grasp, firm grasp, fine manipulation, pinch, finger dexterity, supination/pronation, wrist flexion.
• Frequent torso/back static position; occasional stooping, bending, and twisting.
• Some kneeling, pushing, pulling, lifting, and carrying (not over 25 pounds), twisting, and reaching.

Mental:

• Frequent decision-making. Ability to gather and assess data, determine appropriate actions, apply protocols and knowledge to unique situations, problem-solve and provide consultation.

Work Environment:

Office environment Employees who frequently work in front of computer monitors are at risk for environmental exposure to low-grade radiation.

*Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation.

*The above is intended to describe the general content of and the requirements for satisfactory performance in this position. It is not to be construed as an exhaustive statement of the duties, responsibilities, or requirements of this position. Job descriptions may be updated or changed to reflect business needs.