Executive Director Medical Economics

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary This position is responsible for leading enterprise-wide medical economics strategy to improve the way we analyze medical cost, and how we surface insights to cross-functional stakeholders to help design initiatives to improve medical value. It is the business owner for our Medical Economics Engine (MEE), creating program strategy, defining requirements for capability builds, collaborating with cross-functional executive leaders to provide actionable insights. This is a hybrid role and requires in-office hours 3 days a week at the respective office location. Responsibilities include: 1. Medical Economics Engine (MEE) Development: • Lead the development of our medical economics engine by setting program strategy, defining requirements for capability builds, and overseeing testing and delivery • Collaborate with cross-functional stakeholders (executive leadership, Network, Healthcare Mgmt., etc.) to help define overall program strategy • Own the business requirements and functional strategy for all components of the MEE platform, partnering with delivery (data, IT) teams to oversee feature prioritization, deployment, change mgmt., and user adoption • Ensure MEE reporting and analytics effectively supports business needs 2. Value Improvement (VI) Support • Serve as a core leader for the Value Improvement task force – helping to identify and analyze key cost drivers in healthcare services and ensuring actionable insights are derived to reduce costs and improve value • Gather, synthesize, and present timely and actionable insights on emerging trends, cost drivers, and outlier behaviors – enabling cross-functional leaders to make informed decisions on medical cost containment • Act as the primary point of contact for cross-functional program leads (Healthcare Mgmt., Network, Payment Integrity, PMO, etc.) on medical cost trends and insights • Assist in shortening timelines from opportunity identification to delivery of value improvement, and identify other opportunities to improve the VI process 3. Team Development & People Mgmt. • Direct, coach, and develop team members— from the Director to individual contributor levels • Build the team to support development of additional capabilities (program strategy, AI-enabled insights, etc.) • Foster a collaborative team environment, set goals, monitor performance, and support professional development. Required Job Qualifications: Bachelor’s degree in finance, Actuarial Science, Healthcare Economics, or related field. 12 years of experience in healthcare analytics, medical economics, or financial modeling analysis or 10 years of experience in healthcare analytics, medical economics, or financial modeling analysis with an advanced degree 7 years’ experience in a leadership capacity; ability to lead a team of internal subject matter experts and external strategic advisors Preferred Job Qualifications: Actuarial certification (FSA, etc.). MBA, Master of Finance, Master of Medical Economics, or similar advanced degree. SQL skills or equivalent querying tools experience. Analytics leadership experience with a health insurance payer or provider LI - AZ1 LI - HYBRID Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process! Pay Transparency Statement: At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards. The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. HCSC Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. Base Pay Range $161,500.00 - $299,700.00 Exact compensation may vary based on skills, experience, and location. Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities. Join our Talent Community. For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren’t afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you’ll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations. Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.

Salary : $161,500 - $299,700