VP, Medical Economics

Job Summary

Provides executive level strategy and leadership for team responsible for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities, and improve financial performance and outcomes. Collaborates with health plans to develop scoreable action item (SAI) tracking tools and identify opportunities to improve performance and data management, and support, guide and influence decision-making related to clinical programs, initiatives and strategy.

Essential Job Duties

• Regularly unpacks detailed medical cost information to identify significant trends development and underlying causes of those trends.
• Supports executive strategy development, vision and direction for the enterprise medical economics function including SAI analytics, governance and trend mitigation. Demonstrates accountability for performance and financial results, and keeps executive leadership apprised.
• Recruits, hires, onboards, mentors, develops, and manages a team of medical economics team of professionals.
• Collaborates with senior level clinicians and leaders from functional areas such as finance, health care services and provider contracting to translate analytic observations into meaningful clinical / operational actions and management of clinical services to support, guide and influence decision making related to clinical programs, initiatives and strategy.
• Leveraging targeted analytics, works with business leaders to develop programs to support affordable, high quality health care delivery.
• Identifies gaps in critical information and works with business leaders to develop solutions to capture or supplement information required.
• Informs and supports regular forecasting activities of the enterprise.
• Propagates best medical economics / analysis / SAI development practices across the enterprise.
• Leads enterprise information management (EIM) team to build out data analytic tools and capabilities.
• Develops standards with regard to routine health care economics analyses, including types of analyses performed, frequency by health plan or line of business, etc.

Required Qualifications

Preferred Qualifications

Molina Healthcare offers a competitive benefits and compensation package.