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Director, Cost of Care

Company: Capital BlueCross
Location: Harrisburg
Posted on: April 8, 2021

Job Description:


Responsible for providing thought leadership and directing the efforts of staff supporting cost and trend analysis and other cost of care needs. Guides and oversees process for extracting, assessing, analyzing and interpreting healthcare cost, utilization, quality and financial data. Is responsible for directing the teams' efforts to mine and analyze healthcare data to enable understanding of cost drivers, identification of trends and to timely identify actionable cost savings opportunities.

Collaborates with cross-functional business areas to support and validate data analytics, and to build/improve process for recommending solutions and driving them to implementation. The incumbent ensures appropriate data uses and sources of data; and verifies that sound statistical methods are applied to the analytics. Based on results of data analysis, direct the work to develop interventions and programs to achieve financial opportunity and/or deliver meaningful value in other ways (e.g. improved health equity, quality improvement, etc.) Provide guidance and drive project implementations with cost of care implications.ESSENTIAL DUTIES & RESPONSIBILITIES

  • Assists and leads business in the initial assessments, requirements, project plans, solutions, vendor research and selections, etc. with a focus on initiatives that drive medical cost improvement.
  • Leads and sets strategy for cost of care research related activities, including competitive and industry intelligence; development of models, tools, and data analysis initiatives; and assessment and communication of information and business intelligence to support cost of care team needs.
  • Coordinates the efforts of data analytics from multiple disciplines throughout the organization to maximize efficiency.
  • Communicates results of analysis to various levels of management in a way that demonstrates insights of all relevant business issues.
  • Manage, coach and mentor staff engaged in cost of care activities directly or indirectly.
  • Participates in special projects and performs other duties as needed.JOB REQUIREMENTSExperience:
    • Minimum of 10 years of related experience in healthcare economics or analytics.--
    • Experience in the health care or health insurance industry.
    • Demonstrated experience in strong analytical thinking.
    • Related professional experience as a Medical Economist or Analytics Manager preferred.Education:
      • Prefer a Master's Degree in business administration, mathematics, statistics, health information, economics, and/or health planning and administration with an extensive track record of success in area of accountability. Leadership:
        • Demonstrated project management skills involving multiple departments, customers, and initiatives.
        • Track Record of establishing and maintaining strong relationships with internal customers and working collaboratively in a matrix environment.
        • Ability to communicate effectively in both written and oral form on general as well as complex subject matter in order to reach consensus on issues at the executive level.
        • Ability to analyze problems, requirements, and issues efficiently, determine the impact in the context of the matter being evaluated and develop effective business solutions.
        • Ability to act as a liaison and recommend solutions to a variety of departments, as well as other Plans and other external business partners.
        • Demonstrated staff management skills.Skills:
          • Interact and effectively communicate the need for cross-functional cooperation and managing competing priorities and expectations.
          • Superior analytic skills.
          • Ability to define problems, collect data, establish facts and draw valid conclusions.Physical Demands:
            • While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see.
            • The employee must be able to work over 40 hours per week.
            • The employee must occasionally lift and/or move up to 5 pounds.Travel:Some travel may be required, including local, regional, and national locations. Capital BlueCross is an independent licensee of the BlueCross BlueShield Association. We are an equal opportunity/affirmative action employer and do not discriminate on the basis of race, color, religion, national origin, gender, sexual orientation, gender identity, age, genetic information, physical or mental disability, veteran status, or marital status, or any other status protected by applicable law.-- Capital BlueCross has built a reputation as being "more than" a health insurance company. We are an industry and community leader that understands the foundation of our success is serving people-addressing their needs, guiding them through their health and wellness journey, exceeding their expectations, and giving back to the communities we serve. We could not accomplish these goals without our employees, which is why we work so hard to provide a positive, supporting culture that encourages and rewards excellence. Capital BlueCross offers competitive pay, bonus opportunities, quality benefits, health and wellness incentives, and opportunities for career advancement and community involvement. Our positive workplace culture and employee involvement in our communities have earned us recognition as one of The Best Places to Work in PA and Corporate Citizen of the Year. The success of our company relates directly to the efforts of our dedicated workforce made up of talented individuals, who understand that a career at Capital BlueCross is "more than" simply a job. To experience that kind of opportunity, consider applying to join our fearless team.

Keywords: Capital BlueCross, Harrisburg , Director, Cost of Care, Executive , Harrisburg, Pennsylvania

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