Skip to main content
Data@2X
J187620

Manager Medical Economics

Highmark Inc.

Company :

Highmark Inc.

Job Description : 

JOB SUMMARY

This position will provide leadership and direction to the medical economics team.  The incumbent will lead the development of medical cost analytics across the medical economics team, focusing on providing meaning insights on emerging medical cost trends.  Will focus on analytics that power the execution or business objectives identified by the organization.  Will present the information in a clear and concise manner with the focus on providing meaning insights and potential areas of opportunity to key business leaders.  The incumbent will partner with the Finance and Actuarial teams to fully understand emerging medical cost results and how they compare to expectations. This leader will be responsible for the training, development and workload focused on providing detailed medical cost analytics.

ESSENTIAL RESPONSIBILITIES

  • Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.  Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
  • Lead the medical economics team in the analysis of emerging medical cost trends, the development of  the "story"  and the presentation of the facts in an informative manner to business leaders. 
  • Partner with key analytical partners and business leaders to understand the full medical cost picture, impact of operational changes and changing market dynamics
  • Mentor, coach, train medical economics team so everyone is delivering a high-quality analytic story. 
  • Develop tools, processes, standard formats to improve the overall efficiency of the team
  • Other duties as assigned or requested.

EDUCATION

Required

  • Bachelor's Degree in Mathematics, Finance, Data Science or Actuarial Science

Substitutions

  • 6 years of progressive related experience in lieu of Bachelor's degree

Preferred

  • Master's Degree in Business Administration, Data Science, Mathematics, Public Health or Healthcare Analytics

EXPERIENCE

Required

  • 7 years with Medical Cost Analytics, Actuarial Science, Healthcare Analytics
  • 3 years of Leadership and Management Experience

Preferred

  • None

LICENSES or CERTIFICATIONS

Required

  • None

Preferred

  • None

SKILLS

  • Strong leadership and team development skills
  • Executive level communication skills
  • Ability to present complex analysis and potential areas of opportunity
  • Team development/talent management
  • Medical Economics/Healthcare Analytics/Actuarial Analytics
  • Ability to collaborate across all levels of the organization
  • attention to detail, ability to understand how the facts align to broader strategic view

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required 

Yes

Lifting: up to 10 pounds

Does Not Apply

Lifting: 10 to 25 pounds

Does Not Apply

Lifting: 25 to 50 pounds

Never

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.


As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf )

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice


Thumbnail Join Talent Community@2X

Connect with a career that’s right for you.

Introduce yourself and we'll get in touch monthly to share career insights and company news.

Join Our Talent Community