VP, Medical Economics
E-Verify Program
full-time
Posted on:
Location Type: Remote
Location: North Carolina • United States
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Job Level
About the role
- Drive medical cost management and healthcare value initiatives across the organization.
- Oversee Cost of Care Analytics, Healthcare Value Strategy, and Healthcare Value Operations.
- Partner with executive and health plan leadership, clinical operations, and finance teams to ensure sustainable cost containment and improved healthcare outcomes.
- Lead analytics to support Health Plan clinical operations and care management programs.
- Oversee provider and value-based contracting analytics, including performance measurement and incentive modeling.
- Direct pharmacy economics analysis to optimize drug spend and formulary strategies.
- Oversee evaluation of program ROI for Cost of Care initiatives and recommend enhancements.
- Maintain oversight of medical expense benchmarking and analytical tools for accurate forecasting and reporting.
- Develop enterprise-wide strategies to reduce medical costs and achieve health plan financial targets.
- Collaborate with cross-functional teams to identify opportunities for cost savings and value creation.
- Build business cases for new initiatives, including financial modeling and impact analysis.
- Ensure timely implementation and monitoring of programs designed to improve healthcare value.
Requirements
- Master’s Degree in Health Economics, Finance, Business Administration, Public Health, or related field or Fellow of the Society of Actuaries (FSA)
- 10+ years of experience in healthcare economics, medical cost management, or health plan analytics.
- Proven leadership experience managing large teams and complex initiatives.
- Strong knowledge of health plan operations, provider contracting, pharmacy economics, and value-based care models.
- Exceptional analytical, strategic thinking, and communication skills.
Benefits
- Health insurance
- Retirement plans
- Paid time off
- Flexible work arrangements
- Professional development opportunities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
healthcare economicsmedical cost managementhealth plan analyticsprovider contractingpharmacy economicsvalue-based care modelsfinancial modelingimpact analysiscost of care analyticsprogram ROI evaluation
Soft Skills
leadershipstrategic thinkinganalytical skillscommunication skillscollaborationoversightinitiative managementcost savings identificationvalue creationteam management
Certifications
Master’s Degree in Health EconomicsMaster’s Degree in FinanceMaster’s Degree in Business AdministrationMaster’s Degree in Public HealthFellow of the Society of Actuaries (FSA)