Associate Director Healthcare Economics - Central Region

Overview

The Associate Director Healthcare Economics is accountable for providing support and consultation to local markets and national leaders related to clinical, financial, utilization, and actuarial reporting associated with CINQCARE’s Medicare and Medicaid value‑based care initiatives. The Associate Director reports to the SVP Healthcare Economics and Analytics and embodies CINQCARE’s core values:
Trusted, Empathetic, Committed, Humble, Creative, and Community‑Minded.

• Conduct ad hoc analyses that compare, merge, validate, and summarize multiple or large data sets to track and present solutions for identified business problems.
• Manage interactions and data submissions with payers.
• Assess trends and variables impacting ACO/IPA performance and produce reports, presentations, and dashboards communicating performance, issues, and opportunities.
• Prepare market and business intelligence reports related to value‑based care.
• Perform quantitative and qualitative research on finance and programmatic matters affecting value‑based care programs.
• Create financial pro‑forma analyses modeling business opportunities and structures for various value‑based care payment options.
• Collaborate with practices participating in CINQCARE ACO/IPAs on matters related to areas of responsibility.
• Lead cross‑functional teams to review, analyze, interpret, document, and communicate details of new value‑based care arrangements with payers and providers to support contract negotiations.
• Develop a full understanding of value levers and set performance goals.
• Support financial reporting activities including budget, IBNR, P&L, and forecasting.
• Collect, interpret, and analyze historical claims, premium, capitation, and membership data in support of healthcare analyses.
• Perform data analytics to identify trends, develop programs, and validate programs.
• Understand clinical indicators and appropriate data used to model and evaluate the efficacy and effectiveness of targeted interventions/programs.
• Work with cross‑functional teams to proactively identify opportunities to drive improved economic, health, and humanistic outcomes related to programs.
• Stay current with updates on technology tools and available data sets relevant to programs of interest to CINQCARE and the use of various analytic techniques.
• Support change management for existing processes and help develop standard processes.
• Work with internal teams to embed ongoing reporting needs into the production environment.
• Provide ongoing communications on project status, results, and conclusions.
• Solve complex problems and develop innovative solutions with minimal oversight.
• Act as a subject matter expert.

• Leadership: Lead in defining and executing strategies and solutions to create business value in the ACO/IPA and value‑based care areas, including building a team to design, develop, and execute those strategies and solutions.
• Strategy: Establish the business strategy and roadmap: improve outcomes for CINQCARE members, enhance the efficacy of other CINQCARE business divisions, and deliver external market opportunities for CINQCARE Care products and services; define and innovate sustainable revenue models to drive profitability.
• Collaboration: Ensure that healthcare economics capabilities form a cohesive offering by working closely with other business divisions to learn their needs, internalize knowledge, and define solutions to achieve business objectives.
• Knowledge: Provide subject matter expertise in data‑based analysis and solutions.
• Culture: Maintain a productive, collaborative, safe, and inclusive work environment for the team and the company.

• Education: Bachelor’s degree in economics, statistics, mathematics, actuarial science, or a related field, or 5+ years of equivalent experience in healthcare economics;
  Master’s degree in economics, statistics, finance, business, or health administration (preferred).
• Experience: 5+ years of Medicare‑related experience with payer, provider, or value‑based contracting; experience in an Enterprise Data Warehouse environment or multiple source data warehouses (preferred);
  Medicaid and Medicare…