What are the responsibilities and job description for the Remote Senior Director of Healthcare Cost Management position at Get It - Hospitality?
Join Our Esteemed Organization and Contribute to Transforming Healthcare!
We are a premier establishment committed to enhancing the welfare of over 190,000 workers and their families in the hospitality and gaming sectors nationwide. Our unwavering dedication to innovation and excellence propels us to design beneficial programs that empower our members to take proactive control of their health. We invite you to consider this remarkable opportunity!
Position: Senior Director of Medical Cost Management
In the role of Senior Director of Medical Cost Management, you will be instrumental in formulating and supervising our Medical Cost Management strategy. This position entails spearheading initiatives to analyze medical and pharmacy cost patterns while devising strategic action plans to address identified opportunities and challenges.
Key Responsibilities
We offer an extensive benefits package that includes:
This position presents a dynamic opportunity to significantly influence healthcare cost management. By becoming a part of our team, you will engage in pioneering solutions that empower our members and spearhead transformational initiatives in the healthcare landscape.
Employment Type: Full-Time
We are a premier establishment committed to enhancing the welfare of over 190,000 workers and their families in the hospitality and gaming sectors nationwide. Our unwavering dedication to innovation and excellence propels us to design beneficial programs that empower our members to take proactive control of their health. We invite you to consider this remarkable opportunity!
Position: Senior Director of Medical Cost Management
In the role of Senior Director of Medical Cost Management, you will be instrumental in formulating and supervising our Medical Cost Management strategy. This position entails spearheading initiatives to analyze medical and pharmacy cost patterns while devising strategic action plans to address identified opportunities and challenges.
Key Responsibilities
- Formulate and manage the Medical Cost Management framework, encompassing domains such as payment integrity, high-cost claims, and utilization management.
- Lead the organization in tracking medical and pharmacy cost trends and devise actionable strategies to enhance cost efficiency across clinical programs and networks.
- Develop comprehensive action plans targeting identified opportunities through extensive research of industry standards and vendor solutions.
- Collaborate effectively with Claims, Analytics, Underwriting, and Clinical teams to implement exemplary methodologies for identifying and managing medical cost drivers.
- Utilize both historical and predictive data to recommend benchmarks for evaluating financial and operational performance (KPIs).
- Create metrics and reports to facilitate robust monitoring and analysis of network performance and cost improvement initiatives.
- Partner with data and technology teams to ensure alignment of the company's data strategy with performance monitoring and reporting requirements.
- Cultivate strong interdepartmental relationships, engaging with Executive VPs, Claims, Clinical Operations, Underwriting, and Analytics.
- Assist in establishing an effective staffing model, focusing on internal development and new hires to build a proficient team across various functions.
- Oversee the planning and evaluation of programs and services while considering operational needs and financial constraints.
- Supervise, mentor, and guide team members to foster professional growth and development within the organization.
- Assess challenges, identify innovative solutions, and implement strategies to drive success.
- Contribute to the development and coordination of essential policies and procedures.
- Ensure ongoing employee training requirements are met, alongside the implementation of quality and safety initiatives.
- A minimum of 10 years of relevant experience in healthcare finance, consulting, or healthcare data analysis.
- At least 5-7 years of managerial experience leading teams.
- Proven experience in team development and leadership.
- Proficient in presenting insights to senior leadership across various platforms.
- Expertise in reporting and analyzing healthcare data metrics.
- High competency with query, business intelligence, and statistical tools.
- Strong financial modeling and analysis capabilities to assess ROI in decision-making.
- A Bachelor's degree in Finance, Statistics, Mathematics, Analytics, or a related field is required; a Master's degree in Business Administration or a relevant field is preferred.
- Willingness to travel 15% - 25%.
- Experience in managed care is desirable.
- Salary range: \(176,200 - \)229,100. Actual base salary may differ based on relevant experience and qualifications, certifications, and other pertinent factors.
- Work Schedule: Remote role, Monday-Friday, 7.5 hours per day (37.5 hours per week), plus a travel requirement of 15% - 25%.
We offer an extensive benefits package that includes:
- Medical, Dental, Vision coverage
- Paid Time-Off (PTO) and Paid Holidays
- 401(k) Plan and Pension
- Short- and Long-term Disability coverage
- Life and AD&D Insurance
- Flexible Spending Accounts (healthcare & dependent care)
- Support for Commuter Transit
- Tuition Assistance programs
- Employee Assistance Program (EAP)
This position presents a dynamic opportunity to significantly influence healthcare cost management. By becoming a part of our team, you will engage in pioneering solutions that empower our members and spearhead transformational initiatives in the healthcare landscape.
Employment Type: Full-Time
Salary : $176,200 - $229,100
