This is a fully remote position, open to applicants in Pennsylvania.

📋 Description

• Lead the MedInsight Payer Analytics platform along with a specific portfolio of Medical Economics analytics functions.

• Establish analytic direction and set priorities.

• Manage analytics deliverables, staff, audits, performance models, and reserves.

• Create and uphold analytic standards for financial recast models, as well as utilization and expense trends.

• Supervise product pricing, pricing models and tools, product strategies, and regulatory approvals.

• Direct forecasting, analytics, underwriting, and performance monitoring functions.

• Analyze trends, track financial performance, assess provider, vendor, and reinsurance agreements, and benchmark performance metrics.

• Act as a subject matter expert on regulatory reforms and legislative updates.

• Assist in strategic initiatives through innovative ideas, market research, financial modeling, business plan development, and execution.

• Lead IT teams on data aggregation, partitioning, and extraction rules.

• Collaborate across departments to ensure precise and timely operations.

• Provide mentorship and support to enhance developing actuarial talent.

⛳️ Requirements

• Bachelor's Degree (Required).

• At least 3 years of managerial/supervisory experience (Required).

• A minimum of 7 years of experience in health insurance/managed care (Required).

• Experience in healthcare analytics.

• Background in Medical Economics.

• Proven leadership experience.

• Familiarity with financial recast models, utilization and expense trends, audits, performance analytic models, claim and premium deficiency reserves, product pricing, forecasting, underwriting, performance monitoring, regulatory reform, financial modeling, business plan development, and data management.

• Office Administration skills.