Director, Medical Cost Initiatives - Hybrid (PA/NJ/DE)
The Director of Medical Cost Enablement (MCT) role provides the opportunity for someone to build upon their strong analytic skills and add in their healthcare knowledge to help drive strategies across creating self-funded client value, bending the medical cost curve, and reducing administrative cost burdens. You will lead the financial business case development for high impact initiatives, inform and develop HVO strategies to achieve annual financial goals, drive executive stakeholder agreement, and drive ROI monitoring for medical cost trend reduction programs. You will establish the medical cost strategy for medium and high valued cost initiatives using in depth internal and external information to enable executive decision making. This is a high level, strategic individual contributor role. Additionally:
The Director of Medical Cost Enablement (MCT) role provides the opportunity for someone to build upon their strong analytic skills and add in their healthcare knowledge to help drive strategies across creating self-funded client value, bending the medical cost curve, and reducing administrative cost burdens. You will lead the financial business case development for high impact initiatives, inform and develop HVO strategies to achieve annual financial goals, drive executive stakeholder agreement, and drive ROI monitoring for medical cost trend reduction programs. You will establish the medical cost strategy for medium and high valued cost initiatives using in depth internal and external information to enable executive decision making. This is a high level, strategic individual contributor role.
- Leads the high valued initiatives from business case development and stakeholder agreement through stabilization and ongoing ROI monitoring phases cross functionally.
- Leads financial business case development for new high value initiatives along with ongoing performance assessment of current initiatives
- Drives opportunity analyses aimed at driving strategic revenue targets, innovating in the clinical care space, supporting initiatives to drive process efficiencies, and determining the best course of action for a medical cost reduction strategy
- Supports vendor assessments to determine the true value of a proposed solution.
- Ability to drive projects to completion projects through effective process mapping, collaborate financial projections and analysis.
- Comfort in the “grey” and with a fast fail mindset. Comfortable in winning as a team.
- Develops clear, articulate, actionable business cases in a manner for an executive audience, post implementation stabilization monitoring strategy, ROI monitoring strategy.
- Prepares executive level materials for presentations to SVP / EVP leaders and decision makers.
- Supports the Director & Vice President responsible for overall medical cost program administration and workstream matrix support.
- Supports the HVO leadership team in defining the program-level strategy to achieve medical cost savings targets.
- Ensures data is produced/accurately interpreted; complete investigation of IBC, market/peer precedent, network disruption; packages and facilitates decision making around approach.
- Provides concept and tactical knowledge and support to the assigned implementation program manager through implementation and organizational readiness.
- Lead in managing business issues during the stabilization phase post implementation Lead in monitoring ongoing ROI phase post implementation.
- Leads the preparation of collateral designed to convey overall program status, risks and barriers to senior leaders and executives.
- Leads the preparation of collateral designed to convey the provider abrasion plan for high impact initiatives.
- Understands principles of change management, performance metrics and dialogs, particularly in health systems and drives change at all levels.
- Able to provide leadership over and influence individuals and across multiple stakeholders from different levels / backgrounds by tailoring approach
Qualifications:
· Bachelor's Degree required, advanced degree MBA / MHA etc. desired.
· Healthcare Payor experience highly preferred.
· Management Consulting, Actuary, and / or Finance background desired.
· Clinical background (e.g., nursing or other health-related discipline) is a plus, as it can enhance collaboration with clinical leadership and understanding of operational priorities.
· Ability and comfort in working in a highly matrixed environment to influence and drive decision making
· Strong interpersonal and communication skills, and the ability to present to C suite management.
Hybrid
Independence has implemented a “Hybrid” model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey or Pennsylvania.
IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
Vaccination Update
This job requires that you demonstrate you have been fully vaccinated for COVID-19 prior to the start of employment, to the extent permitted by law.
About Our Company
AmeriHealth Casualty has been successfully returning employees to work since 1994, providing quality medical treatment and care and reducing costs for our customers. With our affiliates, we serve more than 1,800 businesses in the area and have offices in Philadelphia, Camp Hill, and Pittsburgh, PA, and Mount Laurel, NJ.
In 1994, CompServices, Inc. began offering workers’ compensation third-party administration services for manufacturers, municipalities, health care facilities, social services, transportation risk, universities, and retail firms. In 1996, AmeriHealth Casualty Insurance Company was established as an extension of our workers’ compensation claims services — its mission to provide workers’ compensation insurance combined with high quality claims service and cost containment.
AmeriHealth Casualty Insurance Company and CompServices write premiums and administer self-insured programs for over 1,800 customers.
Equal Employment Opportunity
AmeriHealth Casualty is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Agency Disclaimer
All resumes submitted directly to an AmeriHealth Casualty employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of AmeriHealth Casualty and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by AmeriHealth Casualty or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.