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Lead Economic Engineer of Medical Strategy

4 weeks ago

Smithfield, Rhode Island, United States Neighborhood Health Plan of RI Full time
Job Summary

We are seeking a highly skilled Lead Economic Engineer of Medical Strategy to join our team at Neighborhood Health Plan of Rhode Island. As a key member of our Strategic Finance department, you will play a critical role in helping us deliver medical cost savings through data-driven decision making.

Key Responsibilities
  • Work closely with the Clinical Support Team to advance medical cost actions and develop strategies to reduce healthcare costs.
  • Meet with senior leadership and MCA committee to discuss existing and potential actions to impact expenses.
  • Meet with internal and external SMEs to understand healthcare cost trends and identify industry best practices.
  • Analyze complex information, develop reports, and make timely recommendations to Medical Cost Actions team and operational leaders.
  • Lead the design and development of analytical methodologies for evaluating clinical programs and provider performance.
  • Participate in data governance activities and goals.
  • Act as a data or analysis SME within the organization.
Requirements
  • Bachelor's degree with a quantitative emphasis, including business, actuarial science, or computer science.
  • Seven (7) + years of progressive industry experience in data analysis methods, including a strong command of health insurance economics and medical cost drivers.
  • Knowledge of healthcare industry, including familiarity with health policy, health insurance, benefit plans, and provider contracting approaches.
  • Five (5) + years of SQL coding experience.
  • Five (5) + years of data analysis experience using various analysis tools, including analyzing trends and actuarial concepts.
  • Advanced analytical and problem-solving skills, including the ability to approach complex business issues with creative ideas and solutions.
  • Superior communication, facilitation, and presentation skills.
  • Exceptional strategic thinker, able to influence strategic business decisions by providing financial guidance and participation on committees and project groups.
Preferred Qualifications
  • Previous working experience in a Managed Health Care environment.
  • Prior healthcare pricing experience (Underwriting, Actuarial, Network Management, or product development) is preferred.
  • Project management or project experience is preferred to be able to work through multiple priorities and inputs across a multitude of business areas.
About Us

Neighborhood Health Plan of Rhode Island is an equal opportunity employer. We are committed to diversity and inclusion in the workplace. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.