Senior Director, Medical Economics - Cambridge, MA

Massachusetts, New York, United States Minor Outlying Islands

Job Description

 Massachusetts Medical Economics Lead

Responsible for the direction and oversight of reporting and analytics. Develops and manages all critical reports and provides general analysis needed to support strategic decision making. Ensures strategic objectives are met by providing necessary information to business operations, finance, quality, compliance, procurement and clinical functional areas. Works closely with end users and business leaders to understand functional requirements for data mining and advanced analytic solutions. In addition, monitors critical metrics and informs leadership of potential risks. Works collaboratively with national ASD, IT and Medical Economics teams to insure accurate and timely delivery of reports. Ensures all resources are working up to their maximum potential to meet regulatory, customer and internal reporting requirements, meeting all deadlines and following all of the proper policies and procedures. In addition, leads and possibly performs programming and analysis as needed. Requires working knowledge of programming, data mining techniques, application development, and data analysis. Additional duties include providing guidance and mentoring to staff as required, and working with the business owners to set priorities of projects and associated tasks.

Essential Functions

- Works across business areas as the primary focal point to lead the development and management of all internal/external reporting containing critical operational, financial, quality, and compliance metrics needed to support the business. This includes estimates of feasibility, time and effort of tasks and providing updates to both the user community and necessary staff. Monitors projects, determines potential problems and guides them to a successful completion. - Directs the development of tactical and strategic plans to satisfy technical business needs. Leads standardization of data processes to ensure efficient practices that are best in class. - Monitors data and reporting projects, determines potential problems and guides them to a successful completion. Focuses on a larger picture, and pushes toward the strategic vision for their products. - Leads changes/enhancements to business processes, policies, and system infrastructure including project management when needed. Directs and manages business process re-engineering associated with existing, developing and implementation of systems. - Builds a strong local reporting and analytics team through formal meetings, training, coaching, mentoring, and other development techniques. - Performs programming and analysis as needed.

Provides overall financial and analytic guidance and support of Magellan’s Specialty Health Plan businesses. Participates as an active partner of local market health plan operations team in regards to the development and execution of strategy in support of overall business unit objectives.

Provide ongoing medical econimics analytic support of local health plan operations’ business strategy as an active and influential member of the local leadership team.

Support the local health plan operations team in the identification, measurement, tracking, and reporting of medical cost initiative impacts.

Preparation of monthly cost of care financial results anprojections; ensure identification and appropriate treatment of relevant drivers affecting financial results. Summarization and communication of results for leadership.

Represent local health plan interests in regards to corporate medical economics and anlytics data and information governance.

General Job Information

Title

Senior Director, Medical Economics - Cambridge, MA

Grade

31

Job Family

General Services Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

1/29/2019

Date Requisition Created

1/24/2019

Minimum Qualifications

Education

Bachelors: Computer and Information Science (Required), Bachelors: Statistics (Required)

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

  • Bachelors degree in Computer Science, Information Systems, or related field, or equivalent work experience.
  • Demonstrated experience in computer systems and 10+ years experience in technical staff management.
  • Strong development, management and communications skills (verbal and written); experience with systems development lifecycle methodologies (SDLC) and techniques; good project management skills.
  • Excellent verbal and written communication skills; ability to create and lead staff in a team-oriented environment, extensive experience in working as a liaison between technical and non-technical groups; knowledgeable in the use and implementation of SDLC methodologies; proven ability to facilitate meetings.
  • Minimum of seven years of systems analysis/development experience.
  • Experience in the managed care, health care, or insurance industries a plus.
  • Demonstrated experience in computer systems and 10 plus years experience in technical staff management.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled