Manager, Medical Economics

## Manager, Medical Economics Apply:
Remote:
Somerville-MA:
Full time:
Posted Today:
RQ4080194

Site:
Mass General Brigham Health Plan Holding Company, Inc.

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
** Job Summary
** 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.
Responsible for overseeing and managing the financial analysis, modeling, and reporting activities related to healthcare costs, utilization, and outcomes. This role requires a deep understanding of healthcare economics, reimbursement methodologies, data analytics, and business strategy.
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.
-Collaborates 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.
-Leads the development of analytical tools, dashboards, and reports that effectively communicate medical economics insights and recommendations to senior leadership.
-Stays current with healthcare industry trends, regulatory changes, and emerging reimbursement models to inform strategic decision-making.
-Drives the development and implementation of cost containment strategies, medical cost analytics, and performance improvement initiatives.
-Collaborates 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…