What are the responsibilities and job description for the Remote Sr. Director of Cost Management in Medical position at Get It - Hospitality?
Join Our Innovative Team and Shape the Future of Healthcare!
We are a premier organization dedicated to providing exceptional service to over 190,000 workers and their families in the hospitality and gaming sectors nationwide. Our unwavering commitment to innovation propels us to develop impactful programs and benefits that empower our participants to take charge of their health and well-being. We encourage you to consider this remarkable opportunity!
Position Overview: Senior Director of Medical Cost Management
In the capacity of Senior Director of Medical Cost Management, you will architect and lead the Medical Cost Management strategy for our Aurora Plans. This pivotal role entails spearheading the organization’s initiatives to analyze medical and pharmacy cost trends while formulating action plans to bridge any identified gaps or seize emerging opportunities.
Key Responsibilities
This role offers substantial opportunities for professional development, allowing you to lead and inspire a dedicated team while influencing strategic decisions within the healthcare sector.
Compensation And Benefits
Employment Type: Full-Time
We are a premier organization dedicated to providing exceptional service to over 190,000 workers and their families in the hospitality and gaming sectors nationwide. Our unwavering commitment to innovation propels us to develop impactful programs and benefits that empower our participants to take charge of their health and well-being. We encourage you to consider this remarkable opportunity!
Position Overview: Senior Director of Medical Cost Management
In the capacity of Senior Director of Medical Cost Management, you will architect and lead the Medical Cost Management strategy for our Aurora Plans. This pivotal role entails spearheading the organization’s initiatives to analyze medical and pharmacy cost trends while formulating action plans to bridge any identified gaps or seize emerging opportunities.
Key Responsibilities
- Formulate and implement the Medical Cost Management strategy for the Aurora plans, encompassing payment integrity, high-cost claims, complex bill reviews, data integrity, and more.
- Directly monitor trends in medical and pharmacy costs, identifying strategies to enhance cost efficiency within network and clinical operations.
- Construct actionable plans by evaluating industry benchmarks, vendor solutions, and internal requirements.
- Collaborate with Claims, Analytics, Underwriting, and Clinical teams to adopt leading methodologies for identifying and managing medical cost drivers.
- Leverage historical, predictive, and competitive data to propose benchmarks for assessing financial and operational performance (KPIs).
- Create metrics and analytical reports to effectively track and evaluate network performance, condition management, and cost improvement initiatives.
- Work alongside enterprise data and technology partners to ensure seamless integration of data strategies that support program monitoring and stakeholder reporting.
- Cultivate strong interdepartmental relationships, including with Executive VPs and other key stakeholders.
- Assist in developing a robust staffing model to create an effective team management structure.
- Establish a collaborative organizational framework to set and achieve shared goals efficiently.
- Critically assess programs and operational needs while adhering to fiscal constraints.
- Guide, mentor, and develop team members through effective supervision and delegation.
- Analyze challenges, propose alternative solutions, and implement ongoing recommendations.
- Participate in recruitment and promotion decisions for the team.
- Contribute to the formulation and coordination of policies and procedures.
- Oversee ongoing employee training, safety protocols, and quality standards.
- Over 10 years of relevant experience in healthcare finance, consulting, or analytics.
- 5-7 years of leadership experience managing teams.
- Proven ability to build and mentor high-performing teams.
- Strong presentation skills with experience communicating to senior leadership.
- Proficient in healthcare data reporting and metrics analysis.
- Expertise in utilizing query, business intelligence, and statistical tools.
- Skilled in financial modeling and analysis for ROI determinations.
- Bachelor’s degree in Finance, Statistics, Mathematics, Analytics, or relevant field (Master's degree preferred).
- Willingness to travel 15%-25%.
- Managed care experience is a plus.
This role offers substantial opportunities for professional development, allowing you to lead and inspire a dedicated team while influencing strategic decisions within the healthcare sector.
Compensation And Benefits
- Salary range: \(176,200 - \)229,100 (actual salary may vary based on experience and qualifications).
- Work Schedule: Remote role, Monday to Friday, 7.5 hours per day (37.5 hours per week), plus travel requirements of 15%-25%.
- Comprehensive benefits package includes Medical, Dental, Vision, Paid Time-Off (PTO), Paid Holidays, 401(k), Pension, Short- & Long-term Disability, Life Insurance, Flexible Spending Accounts, Tuition Assistance, and Employee Assistance Program (EAP).
Employment Type: Full-Time
Salary : $176,200 - $229,100
