Job Description:
• Build complex financial modeling and lead the design and development of sound financial models to size the impact of UM and affordability strategies. Ensure alignment with corporate savings pipelines.
• Represent the UM department within the broader organization's financial workstreams, ensuring UM initiatives are prioritized and recognized in the corporate savings pipeline.
• Establish and maintain strong relationships with the Medical Economics and Data Science teams to develop vetted methodologies for tracking ROI.
• Own the 'Source of Truth' for the department's value tracking. You will monitor the performance of active initiatives and provide monthly 'True-Up' reports comparing projected savings to actualized results. Develop methods to measure actual performance against expected benefits.
• Build and maintain strong relationships with Medical Economics, Data Science, and Clinical leadership. Translate complex data into 'executive-ready' narratives to influence enterprise-wide decision-making.
• Create data-driven frameworks to help leadership navigate ambiguity and make informed decisions on new strategic investments based on risk adjustment and Medical Loss Ratio (MLR) impact.
• Compliance with all applicable laws and regulations.
• Other duties as assigned.
Requirements:
• 4+ years of experience in management consulting, financial strategic analysis, or healthcare corporate strategy.
• 3+ years of experience in delivering projects / programs.
• Strong understanding of the ACA (Individual/Small Group) business model, including how UM impacts Risk Adjustment and Medical Loss Ratio (MLR).
• 3+ years of expertise in financial modeling, business case development, and cost-benefit analysis.
• Healthcare experience (Health Insurance, Health Systems, or Healthcare Consulting).
Benefits:
• Health insurance
• Paid time off
• Unlimited vacation program
• Annual performance bonuses