 | | Manager of Medical Economics |
| Location: Trenton, NJ | | Salary: $95,000-$105,000 | | Experience: 4.0 year(s) | | Job Type: Full-Time | | Job ID: J117834 |
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A nonprofit healthcare organization seeks an established healthcare professional to join their staff as the Manager of Medical Economics. The qualified individual selected for this position will be responsible for providing oversight and training to a team of Medical Economics analysts. | |
Nonprofit Healthcare Organization | |
The Manager of Medical Economics is responsible for: - Providing oversight, direction, and training to a team of Medical Economics analysts
- Development and implementation of analytic tools and techniques to identify cost of care drivers
- Interpreting results and making recommendations that result in cost reduction and bottom line improvement
- Identifying through data analysis medical cost savings opportunities
- Preparation of reports on medical costs to determine trend, risks, and opportunities related to medical performance
- Monitoring and reporting results of medical cost strategies
- Assisting in the review and evaluation of Medicaid premium rate proposals from the State of New Jersey
- Developing, monitoring and measuring department policies and procedures to ensure consistent utilization reporting
- Understanding and is able to utilize various data sources
- Incorporating metrics and benchmarks (both internal and external) to proactively
- Development and oversight of models for evaluation of provider performance/incentive compensation management
- Assisting with fraud & abuse prevention efforts through data analysis
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- 4+ years in healthcare/managed care experience with direct responsibility for medical analysis and management
- Bachelor's Degree in Accounting, Finance, Info Systems or a related
- Requires understanding of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, product pricing, network and provider contracting, and utilization management
- Technical skills with database concepts, data analysis development, data warehousing, and decision support tools
- Strong attention to detail
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