Job ID: J121417
Company: Gateway Health Plan
Location: Pittsburgh, PA, United States
Full/Part Time: Full time
Job Type: Regular
Posted at: Apr 18, 2018
The Medical Economics Consultant is responsible for the development, coordination and management of health care finance, models and actual results analysis related Value Based Initiatives. This work will leverage market-leading health plan financial planning processes, tools and reporting.
This position will manage Value Based initiatives with business partners and those support functions- who have accountability to implement initiatives in the portfolio. The position will report into the Financial Planning and Analytics department; however, significant emphasis will be placed on frequent and meaningful interactions with business segment and functional department executive/senior leadership to ensure that analytical models are created accurately and in a timely manner. As such, the position will interact with Health Plan Management (SVPs, VPs, Directors, etc.) in formal and informal situations, and must demonstrate a high-level of analytical, communications and influence skills.
Essential Job Functions:
1. Coordinate the oversight and monitoring of the “Creating Customer Value” operating margin improvement effort, driving cross-functional team work efforts to identify, design, implement and monitor initiatives that improve the Organization’s revenue, claims and administrative expenses.
2. Use medical economics experience and knowledge to develop and implement infrastructure to align and explicitly link initiatives’ savings estimates with the financial plans/forecasts, emerging financial results and product pricing.
3. Help develop and implement improved infrastructure and processes to provide management with regular performance scorecards highlighting initiative implementation successes, accountability, “capture” of initiative benefits, activity, progress and identification of barriers. Consistently work with the business and functional area partners to develop a pipeline of new initiatives, seeking to achieve our multi-year financial improvement targets. This effort focuses on operating margin improvement and is positioned to become a normal part of the way the organization does business, and will exist on-going every year. Train business partners in the use of business case return on investment measurement, developing a self-service culture that enables a broad base of support to initiative owners in their efforts to identify potential operating margin improvement initiatives.
4. Develop improved business case and savings estimate capabilities to enable more accurate and deeper projections.
5. Assist in the deployment of an employee-wide communications strategy, highlighting the operating margin improvement challenge and providing regular status reports with respect to achievement of targeted improvements.
6. Lead in a matrixed work environment.
Knowledge, Skills & Abilities:
Referral Award Payout Level: 2
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