Manager, Medical Economics

Location: Westwood, MA
Job ID: 175854-1A
Date Posted: May 18, 2022
Category: Professional

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Job Description

Welcome To

Welcome to the Beth Israel Lahey Health Performance Network (BILHPN). BILHPN is a clinically integrated network of physicians, clinicians, and hospitals committed to providing high-quality, cost-effective care to the patients and communities they serve, while effectively managing medical expense. Leveraging best practices in population health management and data analytics, BILHPN improves care quality and patient health outcomes across Beth Israel Lahey Health through population health initiatives. BILHPN brings together the expertise of more than 4,500 providers across Eastern Massachusetts who share a common goal to achieve success in a value-based delivery system. 

About the Job

Under the supervision of the Director of Medical Economics, the Manager, Medical Economics will be responsible for the oversight of the data systems, processes, and analysis to support financial operations and modeling. The Manager will provide the overall leadership for the production of the quarterly and year end settlement of shared risk contracts under the Funds Flow and the maintenance of all systems and work flows that support this process. The Manager will collaborate with cross-functional leadership in finance, contracting, quality, enrollment and may serve as a project leader for complex data modeling or analysis. The Manager is also responsible for recruitment, coaching and managing the analysts on the team and designing roles for the staff that provide growth opportunities to ensure their continued career development. 

Responsibilities include: 

1. Manage team members building and maintaining the data warehouse and related data systems in support of production of financial analysis relating to performance and settlement of shared risk contracts for BILHPN and individual Risk Units.

2. Oversee the production of quarterly and year end settlement of shared risk contracts under the Funds Flow and all related financial processes such as creation of payor risk rosters, withhold return, and quality incentive

distribution.

3. Lead the implementation of approved changes in the Funds Flow model and the expansion of the data warehouse as needed with supporting enhancements. Apply in-depth knowledge of reimbursement

methodologies, risk-based payor contracts, trends in managed care finance, and actuarial concepts including IBNR.

4. Through clear written and oral communication, explain key analytical findings to all levels of staff and external stakeholders, including Member Physician, hospital leadership and, in collaboration with leadership, relaying information on key aspects of payor contract performance and projected trends.

5. Develops presentations to review financial performance of risk contracts for internal leadership and various committees including but not limited to Contracts & Finance and Board.

6. Prioritize projects, assign resources and create timeline estimates in a manner consistent with organizational financial and strategic goals.

7. Manage stakeholder's expectations and ensure consistency, accuracy, and timeliness of data and analysis for internal and external customers.

8. Is responsible for assuring training is provided to analysts on the team. Manages analysts’ time efficiently and allocates resources appropriately to assure successful completion of projects at hand.

9. Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements; establishes and maintains effective relationships with customers and gains their trust and respect.

10. Communicates effectively with cross-functional teams.

11. Carriers out cross functional tasks to achieve critical organizational milestones.

12. Uses critical thinking skills to analyze information, develops solutions and proposes alternative action plans.

Qualifications: 

  • Bachelor’s Degree or an MBA with Healthcare management focus
  • A minimum of 5-8 years of work experience in healthcare industry and 2-4 years supervisory/management experience required

About Us

Beth Israel Lahey Health is dedicated to improving health and wellness and making a difference in the lives of our patients, their families and all members of the communities we serve.  Formed in March 2019, Beth Israel Lahey Health is a patient-centered, integrated care delivery system providing a continuum of services spanning academic, tertiary and community hospitals, dedicated orthopedic and psychiatric hospitals, primary and specialty care, community acute care, ambulatory care, behavioral services and home health.  Beth Israel Lahey Health Performance Network is a unified joint contracting and population health management organization, jointly governed by participating physicians and hospitals.

Equal Opportunity Employer/Minorities/Females/Disabled/Veterans.