Director of Medical Economics

Job Summary

A company is looking for a Director, Medical Economics/Medical Expense Actuary.

Key Responsibilities

• Develop and implement strategic initiatives to improve medical cost and quality
• Conduct analyses of healthcare utilization patterns and cost drivers to identify improvement opportunities
• Collaborate with internal stakeholders to execute and manage strategies aligned with organizational goals

Required Qualifications, Training, and Education

• 10+ years of experience in Medicare Advantage with a focus on medical expenses and medical economics
• Strong understanding of healthcare delivery systems and reimbursement models
• Ability to operate in a high-growth, ambiguous environment
• Experience with financial drivers of Medicare Advantage health plan operations
• Analytical skills with a hands-on leadership approach