The Senior Director, Healthcare Economics and Data Strategy leads teams responsible for monitoring and identification of key variances and cost saving opportunities within Medical Expense, Population Health Analytics, and Program Evaluations, as well as leadership for Data Strategy and Governance and the HEDIS/Quality team. The Sr. Director collaborates across various departments to support Medica, making informed decisions and implementing the necessary analytics supporting medical expense initiatives across all areas of the company and new and existing Health Management programs. They will lead our Data Strategy and Governance team as well as our team responsible for HEDIS regulatory submissions and Encounter data related to Quality.

The Sr. Director utilizes expertise in analyzing claims, membership, revenue, provider behavior, member behavior, and policy/benefit design to maximize Medica’s medical expense opportunities for overall improvement with a focus on the identification of key trend drivers and cost variation. He/she understands and oversees the development of methodology and models for identifying problems, formulating solutions, and monitoring results. 

The Sr. Director builds relationships with and presents information to segment leadership, health management, and corporate actuarial and finance staff to help achieve financial growth objectives. The Sr. Director also develops new innovative measures and visualization techniques that consistently turn our data into actionable insights that increase the sophistication of our information; providing better access to our stakeholders to aide in advancing analytics and decision making ability. The Sr. Director leads our team that is responsible for Data Strategy and Governance, ensuring that data quality and utility meets the needs of the broader Medica organization. The Sr. Director ensures that processes and policies are followed to produce high quality results and meet regulatory requirements. The Sr. Director coordinates projects that may involve/impact multiple areas of the organization, monitors progress toward goals, and assists in project prioritization and resource planning.

Responsibilities: 

Overall responsibility for development of internal people, processes, technology and competencies to support the Healthcare Economics analytics work stream 20%

• Hires and directs capable team members to develop and support Medica’s Healthcare Economics analytics work stream, Data Strategy and Governance.
• Coaches, develops, and evaluates direct reports.
• Builds a strong cohesive team and facilitates an environment that drives & supports effective collaboration, open communication, and leveraging of individual skill sets to the common purpose.
• Establishes credibility for Healthcare Economics throughout Medica by ensuring analytical processes are accurate and valid.

Oversight of Department Deliverables 40%

• Activities supporting the identification of key variances and cost saving opportunities within Medical and Pharmacy Expense and takes action to advance topics of cost saving opportunities
• Activities to monitor and describe various populations across cost, utilization, and risk variables.
• Application and utilization of our Data Catalog.

Interface with Leaders and Key Customers 40%

• Develops and refines high-level analytics & reporting requirements across diverse set of Medica leaders
• Identifies relationships & commonalities across diverse business needs and suggest opportunities to enhance capabilities through synergy & standardization.
• Recommends and directs priorities across diverse customer needs & multiple complex competing requirements.
• Translates complex technical jargon into meaningful business and IT solutions to facilitate the development of BI solutions.

Qualifications: 

• Bachelor’s degree or equivalent combination of education and experience; Major in Statistics, Mathematics, Actuarial Science, Health Care Management, Finance, Economics; or other related fields
• 10 years experience in Healthcare Economics or similar experience
• Experience working with healthcare data, both structured and unstructured including a demonstrated ability to design, evaluate and interpret complex data sets
• Demonstrated experience leading and developing direct reports

Skills and Abilities:

• Experience within healthcare medical expense analytics
• Demonstrated analytic and problem solving skills
• Ability to develop an analytically derived idea into a clear plan
• Ability to perform validation techniques, as well as perform and interpret a variety of statistical analyses
• The ability to communicate complex problems and solutions in simple language that all can understand
• Ability to work across all areas of the business
• Ability to work in a matrixed team environment

This position is an Office role, which requires an employee to work from the designated office, Minnetonka, on average, 2 times per week.

The full salary range for this position is ($143,500 - $246,000). Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to base compensation, this position may be eligible for incentive plan compensation in addition to base salary. Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.

The compensation and benefits information is provided as of the date of this posting. Medica’s compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.

Medica's commitment to diversity, equity and inclusion (DEI) includes unifying our workforce through learning and development, recruitment and retention. We consistently communicate the importance of DEI, celebrate achievements, and seek out community partnerships and diverse suppliers that are representative of everyone in our community. We are developing sustainable programs and investing time, talent and resources to ensure that we are living our values. We are an Equal Opportunity/Affirmative Action employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.