Vice President, Cost Management – Affordability

Accountabilities

- Develop, implement, and oversee enterprise-wide affordability strategies and cost-of-care management initiatives aligned with organizational priorities.

- Establish measurable affordability goals, financial targets, and performance indicators to monitor healthcare expenditure and improve financial sustainability.

- Analyze healthcare utilization patterns, service costs, and financial trends to identify the root causes of rising expenditures and opportunities for improvement.

- Collaborate with leaders across Clinical Operations, Care Management, Utilization Management, Network Management, Population Health, Medical Economics, Finance, and Pharmacy to design and implement cost-reduction strategies.

- Identify opportunities to reduce unnecessary healthcare utilization and cost growth while maintaining high-quality outcomes and appropriate member access to care.

- Oversee financial impact assessments, business cases, and financial modeling for proposed affordability initiatives, ensuring expected savings and outcomes are clearly defined.

- Translate analytical findings into practical intervention plans, actionable recommendations, and sustainable cost management solutions.

- Drive cross-functional execution and accountability, ensuring affordability initiatives are implemented effectively and deliver measurable results.

- Monitor the financial and operational performance of cost management programs, assess progress against established targets, and recommend adjustments when necessary.

- Prepare and present executive-level reports, financial analyses, strategic recommendations, and performance updates to senior leadership.

- Lead and develop teams responsible for cost management and affordability initiatives, fostering collaboration, accountability, and continuous improvement.

Requirements:

- Education and experience: Bachelor's degree with at least six years of relevant healthcare experience, or a master's degree with at least three years of relevant experience. Experience must include work in government-sponsored healthcare programs, managed care, healthcare operations, population health, medical economics, healthcare finance, utilization management, payment integrity, network management, affordability, or a related healthcare environment.

- Financial and analytical expertise: Demonstrated experience in financial project management, healthcare data and trend analysis, healthcare economics, cost management, affordability management, financial controls, payment integrity, financial modeling, or managing large-scale medical and behavioral healthcare expenditure targets.

- Leadership experience: At least two years of supervisory experience managing a minimum of two employees, with the ability to lead teams, develop talent, and drive performance.

- Preferred education: Master's degree in Business Administration, Healthcare Administration, Finance, Economics, Public Health, or a related discipline.

- Preferred professional background: Ten or more years of progressively responsible experience in Medicaid managed care, Tailored Plans, LME-MCO organizations, healthcare economics, medical economics, affordability management, healthcare finance, population health, utilization management, network management, or government healthcare programs.

- Strategic leadership: Proven ability to lead enterprise-wide cost management initiatives and implement strategies that influence healthcare expenditure trends and improve affordability.

- Analytical and financial skills: Strong understanding of healthcare financial performance, cost drivers, utilization trends, financial forecasting, and the development of measurable savings initiatives.

- Communication and stakeholder management: Excellent interpersonal, presentation, and communication skills, including the ability to translate complex financial and healthcare data into clear recommendations for executive leadership.

- Collaboration and problem-solving: Ability to work effectively across multidisciplinary teams, influence senior stakeholders, and drive organizational change in a complex healthcare environment.

- Additional requirements: Must hold a valid driver's license, reside within the United States, and be legally authorized to work in the United States without current or future employment sponsorship.

Benefits:

- Annual salary: $144,763–$180,479, depending on qualifications and experience.

- Remote work opportunities for most positions, including this United States-based leadership role.

- Flexible working arrangements available with management approval.

- Typical working hours of 8:30 a.m. to 5:00 p.m.

- Comprehensive health insurance with no employee premium for individual coverage.

- Flexible Spending Accounts (FSA).

- Generous paid time off, including 24 days of PTO and 12 paid holidays during the first year.

- Participation in the North Carolina Local Government Retirement System (LGERS), offering a defined-benefit pension plan.

- 401(k) retirement savings plan with a 5% employer match and immediate vesting.

- Eligibility as an employer for the Public Service Loan Forgiveness (PSLF) program.

- Quarterly stipend to support remote work supplies.

- Collaborative, mission-driven working environment.

- Opportunities for professional development and career growth within an inclusive and diverse organization.

How Jobgether works:
We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.
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