Director, Medical Economics

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In accordance with Colorado's EPEWA Equal Pay Transparency Rules.

Help lead health care into the future. As one of the largest nonprofit health systems in the country, Banner Health has both the stability that comes with success and the values you can be proud to represent. If you're looking to leverage your abilities - you belong at Banner Health.

The Director Medical Economics will be a part of the Actuarial leadership team for the Banner Health Insurance Division. The Director will ensure standardized reporting across all products and will identify, evaluate and analyze emerging medical and pharmacy trends to present cohesive reporting to executive leadership. This role will function as an expert in all areas of healthcare data to assist with the understanding of risk for the Banner government and commercial insurance populations.

Your pay and benefits are important components of your journey at Banner Health. This opportunity is also eligible for our Management Incentive Program, as part of your Total Rewards package. Banner Health offers a variety of benefits to help you and your family. We provide health and financial security options so you can focus on being the best at what you do and enjoying your life.

Your pay and benefits are important components of your journey at Banner Health. This opportunity includes the option to participate in a variety of health, financial, and security benefits. In addition, this position may be eligible for our Management Incentive Program as part of your Total Rewards package.

Banner Health Network (BHN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BHN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs.

POSITION SUMMARY

This position will report to the top Actuary executive and will be responsible for managing a team which performs critical analyses to improve the financial performance of the Banner Insurance Operations. The Director will ensure standardized reporting across all products and will evaluate, analyze and communicate key opportunities within each product to leadership. This role will also be responsible for partnering with clinical leadership in developing the required reporting to improve quality and financial performance of the Primary Care Physicians (PCPs), Specialist, and Hospitals within our network.
Primary responsibilities include conducting analysis of insured medical populations with the goal of identifying opportunities to improve financial performance and other data sources to identify emerging trends or other issues related to medical care cost. The Director will extract, analyze, and synthesize data from various sources to identify risks and opportunities. This role will be responsible for drawing actionable conclusions based on analysis performed and communicate those conclusions effectively to audiences at various levels of the enterprise. This role will also be responsible for working closely with clinical, provider network and other personnel to bring supplemental context and insight to data analysis, and design and perform studies related to quantification of medical interventions. In addition, the Director will perform pro forma sensitivity analysis in order to estimate the expected financial value of proposed medical cost improvement initiatives. This individual will work with business owners to track key performance indicators for medical interventions and with the ability to mine and manage information from large data sources compile information from various systems to support executive decision-making.

CORE FUNCTIONS
1. Directs, supervises, and evaluates the work of direct staff and matrixed employees.

2. Participates into the development of the department budget to meet corporate goals and objectives. Meets annual budgetary goals. Translates organizational plans, goals, and initiatives into assumptions for annual operating and/or capital budgets. Negotiates contracts with external vendors for products and/or services and monitors/evaluates quality and/or performance.

3. Directs and participates in the development, implementation, and consistent application of effective organizational policies, procedures, and practices. Develops and supports internal controls to ensure that assets are safeguarded, policies and operating procedures are followed, necessary controls are effective and efficient, and compliance with current laws and regulations is achieved.

4. Reviews, prepares, analyzes, and presents reports and recommendations to senior leadership regarding operations, programs, services, and/or other applicable areas of interest in order to provide concise and accurate information that aids in decision-making.

MINIMUM QUALIFICATIONS

Bachelor's Degree in Finance, Statistics, Mathematics, Actuarial Science, Business, Accounting, Economics, or Healthcare Administration.

Experience delivering and communicating results to executive leadership on a regular basis; five or more years of actuarial, medical economics, or healthcare analytics experience.

Knowledge of software for data analysis; specifically, spreadsheets (e.g. MS Excel, VBA), data extraction and manipulation (e.g. SAS, Teradata, R) and data visualization (e.g. Tableau).

PREFERRED QUALIFICATIONS

Master's Degree (e.g. MBA, MPH, MHA, etc.)
Two or more years managing a team of analysts.

Additional related education and/or experience preferred.

DATE APPROVED 10/04/2020