Senior Vice President, Medical Economics

Senior Vice President, Medical Economics About the Company Join a distinguished health plan dedicated to serving the local community. Industry Hospital & Health Care Type Non Profit Founded 1937 Employees 1001-5000 Categories Health & Wellness Health Care Association Communities Non Profit Specialties Healthcare insurance Alternative quality contract Community partnership Business Classifications B2C E-Commerce About the Role We are seeking a dynamic and visionary Senior Vice President for Medical Economics to spearhead the design, development, and execution of financial analytics driving our affordability agenda. In this vital leadership role, you will oversee extensive business case analytics, manage medical cost council teams, and ensure robust trend oversight. The successful candidate will possess the ability to clearly convey the total value of trend management initiatives spanning medical policy, payment policy, care management, pharmacy, and well-being programs. Your expertise will be critical in developing and maintaining comprehensive trend management initiative tracking tools and generating actionable insights that will guide pricing, financial planning, and executive decision-making. Collaboration with key business partners and the capacity to influence the development of innovative initiatives are essential in this role. We are looking for applicants with deep healthcare delivery system knowledge and health plan operations experience, specifically in medical economics, trend management, pricing, forecasting, and provider payment methodologies. Ideal candidates will be strategic thinkers with excellent communication and presentation skills, able to influence stakeholders at all levels. A solid foundation in data science techniques—including machine learning and artificial intelligence—is required to navigate the complexities of medical cost and trend drivers. To qualify, you should have a minimum of 10 years of healthcare experience with direct leadership and management expertise, in addition to holding a BA/BS degree; an advanced degree such as an FSA, MBA, or equivalent is preferred. As the Senior Vice President, you will lead analytics coordination, ensure compliance with regulatory standards, and foster a culture of continuous professional development within your team. Hiring Manager Title SVP & Chief Actuary Travel Percent Less than 10% Functions Medical Care/Hospital Administration