Job Description

Your career starts now. We're looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we're passionate about helping people get care, stay well , and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you. Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at . **Job Summary** Under the senior leadership of the Medical Economics group, this position will provide strong leadership in the planning, development, and execution of reporting, information, and data policies, activities, and products that drive the achievement of strategic goals and business success for the Total Cost of Care Program. This leader will enable innovative reporting, technology, and application solutions to support business needs. They will provide actionable insight, to lead markets and the organization towards a best-in-class Total Cost of Care Model. They will ensure that an appropriate medical economics discipline is incorporated into all reporting and analytics. Knowledge of Provider Reimbursement Methodologies is required. **Essential Functions** - Lead team in development of Tools as we expand our Medical Economics playbook that lend to providing actionable insight to the organization with regards to Total Cost of Care. - Demonstrates excellent staffing capabilities through effective hiring, staff development, and strong performance management. - Synthesize data that leads to collaborative discussions with various markets/departments, with the goal of identifying actionable outcomes to improve a market's Total Cost of Care. - Effectively present and communicate findings to various aspects of the business tailoring the communication to our business partners. - Engage with various business groups to create a cohesive/accountable structure for understanding business dynamics, potential areas for improvement, and areas with best-in-practice processes that can be used throughout the organization. - Ability to analyze Medical & Pharmacy utilization and cost trends. - Execute root cause analysis and recommendation of corrective actions. - Identification of emerging issues using data analytics and tools. - Provide analytical support to drive the execution of initiatives. **Education/Experience** - Bachelor's Degree in Actuarial Science, Economics, Computer Science, IT, IS, or a related field required; Masters preferred - 10 or more years of experience years of health plan analytics with in-depth analytics, technical expertise, and business knowledge - Strong project management, analytical and problem-solving skills, and the ability to work with and through people to achieve exceptional results. - 7+ years experience in presenting analytic results. - 7 + years experience in healthcare data analysis and information reporting. Facilitation, decision-making, organizational/business expertise, and analytical skills. - 7+ years experience with SQL and Tableau / Power BI - Proficient in MS Office (Outlook, Word, Excel, PowerPoint, Teams. - Strong verbal and written communication skills. **Diversity, Equity, and Inclusion** At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve. We keep our associates happy so they can focus on keeping our members healthy. **Our Comprehensive Benefits Package** Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more. As a company, we support internal diversity through: Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.

Job Tags

Holiday work, Remote job, Flexible hours,

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