Job Information
Highmark Health Manager Medical Economics in Pittsburgh, Pennsylvania
Company :
Highmark Inc.
Job Description :
JOB SUMMARY
This position will provide leadership and direction to the medical economics team. The incumbent will lead the development of medical cost analytics across the medical economics team, focusing on providing meaning insights on emerging medical cost trends. Will focus on analytics that power the execution or business objectives identified by the organization. Will present the information in a clear and concise manner with the focus on providing meaning insights and potential areas of opportunity to key business leaders. The incumbent will partner with the Finance and Actuarial teams to fully understand emerging medical cost results and how they compare to expectations. This leader will be responsible for the training, development and workload focused on providing detailed medical cost analytics.
ESSENTIAL RESPONSIBILITIES
Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
Lead the medical economics team in the analysis of emerging medical cost trends, the development ofthe "story"and the presentation of the facts in an informative manner to business leaders.
Partner with key analytical partners and business leaders to understand the full medical cost picture, impact of operational changes and changing market dynamics
Mentor, coach, train medical economics team so everyone is delivering a high-quality analytic story.
Develop tools, processes, standard formats to improve the overall efficiency of the team
Other duties as assigned or requested.
EDUCATION
Required
- Bachelor's Degree in Mathematics, Finance, Data Science or Actuarial Science
Substitutions
- 6 years of progressive related experience in lieu of Bachelor's degree
Preferred
- Master's Degree in Business Administration, Data Science, Mathematics, Public Health or Healthcare Analytics
EXPERIENCE
Required
7 years with Medical Cost Analytics, Actuarial Science, Healthcare Analytics
3 years of Leadership and Management Experience
Preferred
- None
LICENSES or CERTIFICATIONS
Required
- None
Preferred
- None
SKILLS
Strong leadership and team development skills
Executive level communication skills
Ability to present complex analysis and potential areas of opportunity
Team development/talent management
Medical Economics/Healthcare Analytics/Actuarial Analytics
Ability to collaborate across all levels of the organization
attention to detail, ability to understand how the facts align to broader strategic view
Language (Other than English):
None
Travel Requirement:
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office-based
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
Yes
Lifting: up to 10 pounds
Does Not Apply
Lifting: 10 to 25 pounds
Does Not Apply
Lifting: 25 to 50 pounds
Never
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
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Req ID: J254862