Company Statement
ConnectiCare is a leading health plan in the state of Connecticut. ConnectiCare’s mission is to make it easy for members to get the care they need. A local company for over 35 years, ConnectiCare has a full range of products and services for businesses, municipalities, individuals and those who are Medicare-eligible. A subsidiary of EmblemHealth, ConnectiCare leads the individual and small group markets in the state, and is ranked among the top commercial health plans in the nation, according to the National Committee for Quality Assurance.
We’re looking for individuals who want to make a difference in the communities we serve. If you want to join a local team and help change the way health care is delivered, ConnectiCare is the place for you.
Manager, Medical Economics
Summary of Position
• Manage a team of financial analysts to meet the key initiatives of the company: provide timely, accurate, actionable data and analysis supporting the department, area, and corporate key initiatives.
• Develop initiatives to increase profitability and decrease medical expenses.
• Develop plans, provide resources, and direct activities for provider financial analysis.
• Proactively initiate and develop analytics for strategic and operating decisions and provide recommendations to senior management on both tactical and strategic nature.
• Participate as a key strategic member of Management.
• Develop and maintain collaborative relationships.
Principal Accountabilities
• Manage and supervise the Medical Economics staff to facilitate standard reporting and ad hoc analysis.
• Manage and develop direct reports (including supervisory personnel and/or exempt individual contributors).
• Develop strategies and ensure maximum efficiencies in the utilization of human and financial resources.
• Develop the workflow of and oversee the financial analysts by prioritizing projects and establishing expectations with the department’s internal and external customers.
• Lead and manage meetings to facilitate communications in regional initiatives to improve operating results.
• Oversee Medical Economic projects and initiatives, direct all necessary follow-ups and communicate results and recommendations to senior management.
• Plan, conduct and direct work on complex projects/programs necessitating the origination and application of new and unique approaches.
• Oversee and conduct monthly analysis identifying opportunities to reduce cost and utilization, to include review and dissemination of reports with summary overviews to highlight issues facing the organization.
• May proactively evaluate the government reimbursement process to determine areas of risk and opportunity and provide senior management with necessary updates and/or strategic recommendations.
• Manage the financial analysis of medical cost.
• May oversee the contract modeling process
• Develop and provide actionable recommendations to senior management relative to all analysis and/or ad hoc reporting.
• Advise management in long-range planning for areas of specialization.
• Provide technical direction to functional managers, other directors and management.
• Recommend changes in area(s) policy and procedure
• Participate in special projects and perform other duties as directed/required.
Education, Training, Licenses, Certifications
• BA/BS in Mathematics, Economics, Healthcare, or other quantitative discipline. (Required)
Relevant Work Experience, Knowledge, Skills, and Abilities
• 5 – 8+ years of experience in relevant health care or industry experience. (Required)
• Experience in staff and process management. (Required)
• Strong skills in analytical/problem solving and presentations. (Required)
• Effective presentation of reporting and analytic results. (Required)
• Knowledge of standard health care metrics for payer and provider reporting. (Preferred)
• Strong communication skills (verbal, written, presentation, interpersonal). (Required)
• Proficient in MS Office (Word, Excel, PowerPoint, Teams, Outlook, etc.), with expertise in Excel. (Required)
• SAS or SQL experience. (Required)
• Knowledge of Tableau. (Preferred)
EEOC Statement
We are committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law.