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Director, Medical Cost Transformation Enablement - Hybrid (PA/NJ/DE)

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Health & Clinical Services
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250519 Requisition #

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:

  • 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:

  • Ability and comfort in working in a highly matrixed environment to influence and drive decision making
  • Bachelor's Degree required, advanced degree MBA / MHA etc. desired.
  • Management Consulting, Actuary, and / or Finance background desired. 
  • Healthcare Payor experience highly preferred.
  • Appropriate designations ASA, FSA, and / or CPA preferred but not required.

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.

Inclusion and Belonging

At IBX, everyone can feel valued, supported, and comfortable to be themselves, and all associates have a fair opportunity to achieve their full potential.  We put these principles into action every day by acting with integrity and respect.  Celebrating and embracing diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

About Our Company

Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day.

 

At Independence, we see each of our members as an individual, with unique needs and concerns. We’re dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations.  For more information about Independence access our website at www.ibx.com. We’re revolutionizing health care, and our focus is on you!

 

Equal Employment Opportunity

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.

 

Agency Disclaimer

All resumes submitted directly to an Independence Blue Cross 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 Independence Blue Cross and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by Independence Blue Cross or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process. 

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