Manager, Medical Economics

Mass General Brigham Health Plan Position

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are at the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage. Our work centers on creating an exceptional member experience a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills. We are pleased to offer competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more.

Essential Functions

• Develop and manage the medical economics strategy, ensuring alignment with organizational goals and objectives.
• Analyze and interpret healthcare claims, utilization patterns, and cost data to identify trends, opportunities for cost savings, and performance improvement.
• Conduct complex financial modeling and forecasting to assess the financial impact of healthcare initiatives, policy changes, and reimbursement strategies.
• Collaborate with internal stakeholders, including finance, actuarial, clinical, product, and network management teams, to design and evaluate population-based health interventions and value-based payment models.
• Lead the development of analytical tools, dashboards, and reports that effectively communicate medical economics insights and recommendations to senior leadership.
• Stay current with healthcare industry trends, regulatory changes, and emerging reimbursement models to inform strategic decision-making.
• Drive the development and implementation of cost containment strategies, medical cost analytics, and performance improvement initiatives.
• Collaborate with data management and IT teams to ensure the availability, accuracy, and integrity of medical economics data and reporting systems.

Qualifications

Education

• Bachelor's Degree required and Master's Degree preferred (experience can be considered in lieu of a degree)

Experience

• At least 8-10 years of experience in healthcare economics, financial analysis, or a related field, preferably within a healthcare setting, required
• At least 5-7 years of experience in a supervisory or management role required
• Experience working for another healthcare payer highly preferred
• Experience working with regulators highly preferred

Knowledge, Skills, and Abilities

• Strong knowledge of healthcare reimbursement methodologies, payment models, and industry regulations (e.g., Medicare, Medicaid, Commercial insurance).
• Demonstrated experience in healthcare data analysis, including claims data, utilization metrics, and cost drivers.
• Proficiency in SQL, SAS, or other data analysis tools.
• Proven ability to develop financial models, conduct cost-benefit analysis, and perform forecasting.
• Strong strategic thinking and business acumen, with the ability to translate complex data into actionable insights and recommendations.
• Proficient in using data visualization tools (e.g., Tableau, Power BI) to present complex information in a clear and concise manner.
• Exceptional communication and presentation skills, with the ability to effectively convey complex concepts to both technical and non-technical stakeholders.

Additional Job Details (if applicable)

Working Conditions

• This is a remote role that can be done from most US states
• Monday through Friday eastern business hours required
• Remote workdays require a stable, secure, quiet, and HIPAA-compliant workspace. This will be confirmed via Microsoft Teams video for all employees

Remote Type

Remote

Work Location

399 Revolution Drive

Scheduled Weekly Hours

40

Employee Type

Regular

Work Shift

Day (United States of America)

Pay Range

$117,707.20 - $171,204.80/Annual

Grade

8