Job Details

A company is looking for a Director of Health Plan Economics.Key ResponsibilitiesDevelop and maintain risk stratification frameworks for care management and disease management programsBuild predictive models for hospitalization and care gap closure, translating insights into actionable recommendationsLead and mentor a high-performing analytics team while overseeing cross-functional governance of measure definitionsRequired QualificationsMinimum of 10 years of experience in healthcare analytics or related fieldsAt least 10 years of managerial experienceBachelor of Science in Business requiredAdvanced proficiency with medical and pharmacy claims data and predictive modeling tools; SQL required, Python or R preferredDeep understanding of CMS Medicare Advantage payment methodologies and value-based care economics