About this role
The Sr. Director, Medical Economics & Informatics, will be responsible for the management & delivery of practice performance, medical economic & data science related outputs which impact the quality and cost performance of Integra Connect customers. This position will identify and design medical economic and analytics products (technology, reports, analyses, etc.) that optimize the performance measurement, improvement opportunities, and performance forecasting through use of clinical, administrative, and paid claims data from third party payers. This role will develop actionable, data-driven insights through research and analysis of data sources (paid as well as pre-adjudicated claims, Electronic Health Records, Billing, Lab, Genomic, Socioeconomic) and development of statistical, mathematical, and predictive analyses along with the Population Health staff.
This role is critical for translating medical economics, clinical & statistical aspects of value-based care into business solutions through requirements definitions with product development teams.
Additional responsibilities include supporting ad hoc customer requests, design and analysis associated with a wide range of alternative payment models (APMs), and value-based contracts with third party payers. This role also supports sales and other Integra Connect stakeholders with medical economics and analytical services .
Responsibilities:
- Designs, develops, and manages the Medical Economics & Informatics services for Integra Connect Population Health clients with a focus on value-based care, precision oncology and alternative payment models; solution examples include Predictive Analytics using AI/Machine Learning, Cost, Utilization and Quality analysis, Clinical Practice Patterns and Care Path analysis, HCC Coding analysis, Payer APM Risk analysis, Provider Performance Benchmarking, Treatment Outcomes, and Comparative Effectiveness analysis.
- Collaborates with cross-functional SME and engineering teams on the governance, design and management of data models, data acquisition, data transformation and data curation needed to support Population Health and Precision Oncology analytics.
- Collaborates with cross-functional SME and engineering teams on the design, development, and operation of technical platforms and tools to support Population Health and Precision Oncology analytics.
- Oversees and manages the Population Health Medical Economics and Informatics team, both in the development of Population Health products and services, and in the support of customers using its services, working with customers to identify insights and trends, answer questions, and perform ad hoc analyses as needed.
- Works with Payer Contracting resources to support the development, implementation, and performance management of APMs and other value-based reimbursement contracts with third-party payers.
- Translates medical economics, clinical & statistical aspects of value-based care into business solutions that drive financial results for the company.
Qualifications
- 10+ years of progressive Medical Economics & Analytics experience within payers, providers, analytics firms and/or consulting firms supporting Population Health, ACOs, Oncology Medical Homes, Risk Contracting and/or Precision Oncology.
- Hands-on experience in using analytics tools, such as R, Python, SAS, AI/Machine Learning, SQL Queries.
- Experience working with a wide range of healthcare data sets (Oncology data experience preferred), in particular, expertise with payer claims data
- Experience working with product development teams.
- Progressive management experience.
- Predictive modeling and risk prediction algorithms.
- Proven track record of translating medical economics and value-based care clinical aspects into actionable business solutions for clients and Integra Connect operations.
- Ability to travel up to 20% of the time.
- Ability to work in a dynamic, fast-paced environment.
Preferred Qualifications:
- Bachelor’s or Masters (preferred) degree in Statistics, Medical Economics, Analytics, or a similar field required.
Benefits:
Integra Connect, LLC provides a comprehensive benefits plan
- Medical/Dental/Vision Insurance beginning the 1st of the month following your date of hire
- Paid Time Off
- 401k with employer match
- Paid Holidays and Floating Holiday
Equal Opportunity Employer
Please note that the deadline for submitting applications is DATE. All applications must be received by this date to be considered.