Amerihealth Caritas

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. 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 www.amerihealthcaritas.com .

Manager Medical Economics & Business Process

Location

United States

Posted

1 day ago

Salary

0

Seniority

Lead

No structured requirement data.

Job Description

Manager Medical Economics & Business Process

Amerihealth Caritas

Role Description The Manager, Medical Economics & Business Process leads a team responsible for delivering healthcare data and medical economics analyses across a variety of data sources, including claims, authorizations, member, and provider data. This role partners closely with cross-functional teams to structure and execute analyses, generate insights, and identify opportunities to improve medical costs, operational performance, and overall business outcomes. This is a hands-on role, which combines team leadership with active analytic contributions to core workstreams. Work Arrangement: Remote - This position is fully remote and may be performed from any location within the United States; however, the associate is required to work during Eastern Standard Time (EST) hours. Responsibilities - Lead complex analyses addressing healthcare cost, utilization, and operational performance using internal and external data sources. - Demonstrate a comprehensive understanding of key drivers of healthcare trends and effectively synthesize complex concepts for diverse audiences. - Serve as a trusted advisor to business partners by translating medical costs and operational insights into strategic opportunities and recommendations. - Mentor, develop, and lead a high-performing analytics team focused on market-level and enterprise healthcare financial and operational data. - Collaborate and build strong relationships with cross-functional partners to understand business questions and deliver actionable insights. - Translate business needs into clear analytic requests and guide the development of appropriate methodologies. - Design and develop innovative analytic solutions, tools, and approaches to address complex business problems. - Work comfortably with large, complex, and diverse healthcare data sets to support decision-making and performance improvement. Qualifications - Bachelor’s degree in actuarial science, economics, computer science, or a related field required. - Master’s degree is preferred. - 5 to 10 years of health plan analytics with in-depth analytics, technical expertise, and business knowledge. - 5 years of experience presenting analytical results. - 5 years of experience in healthcare data analysis and information reporting. - 5 years of experience with SQL, Tableau, and PowerBI. - Facilitation, decision-making, organizational/business expertise, and analytical skills. - Leadership, supervisory, or team-leader experience. Skills & Abilities - Strong understanding of Medicaid managed care, healthcare, and operational data. - Advanced analytical and problem-solving skills with the ability to address complex business questions. - Advanced capabilities in pulling, validating, and synthesizing data to derive actionable insights for the organization. - Excellent verbal and written communication skills, with the ability to clearly convey insights to technical and non-technical audiences. - Proven leadership and mentoring skills, with experience developing high-performing analytic teams. - Strong organizational skills and ability to manage multiple priorities in a fast-paced environment. - Ability to think strategically while maintaining attention to detail and data accuracy.

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