Presbyterian Healthcare Services

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MANAGER, MEDICAL ECONOMICS

at Presbyterian Healthcare Services

Posted: 2/26/2019
Job Status: Full Time
Job Reference #: 19006
Keywords: operations

Job Description

About Us

Presbyterian Healthcare Services is a locally owned, not-for-profit healthcare system of eight hospitals, a statewide health plan, and a growing multi-specialty medical group. Founded in New Mexico in 1908, it is the state's largest private employer with approximately 11,000 employees.

 

Presbyterian's story is really the story of the remarkable people who have chosen to work here. Starting with Reverend Cooper who began our journey in 1908, the hard work of thousands of physicians, employees, board members, and other volunteers brought Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system, serving more than 700,000 New Mexicans.

 

We are part of New Mexico's history - and committed to its future. That is why we will continue to work just as hard and care just as deeply to serve New Mexico for years to come.

 

Job Description 

Type of Opportunity: Full Time

FTE: 1.000000

Exempt: Yes

Work Schedule: Days

Location: Rev Hugh Cooper Admin Center

 

Education:
Essential:
* Bachelor Degree

 

REQUIREMENTS:
*Bachelors degree in healthcare, accounting, finance or other quantitative/related field. Masters degree preferred.
*6 years healthcare industry experience specifically medical economics/ interpreting/ analyzing product performance. Must have solid knowledge of most aspects of health plan operations and direct analytics experience working with most areas including but not limited to: medical management programs, population health programs, utilization management, care coordination, reimbursement methodologies, provider contracting including incentive strategies and value-based reimbursement, claims payment, system configuration, sales/employer group reporting, premium development, finance and actuarial.
*Solid knowledge of healthcare industry and healthcare information standards such as ICD9/10, CPT codes, HCPCS codes, MS-DRG, ETGs, RBRVS, Utilization per K, PMPM, etc.
*Technical Skills: must possess strong technical skills in Microsoft Office Applications (Excel, Access, Word, PowerPoint) as well as experience using analytical/reporting applications such as Business Objects or other BI tools. Experience preparing PowerPoint presentations/ visualization of complex information in a simplified yet powerful manner.

 

Summary:

This position will play a consultative role in helping to set the strategy and pricing and will be the financial expert within the product line. The position will work closely with pricing, clinical operations, provider network, provider contracting, and finance. Interpret, analyze, communicate and provide strategies related to the overall plan results of for a specific product line (i.e. Commercial, Medicare, Medicaid). Highly experienced medical economics analyst will use data from various sources to holistically analyze and communicate health plan performance for a specific product line, including how programs and strategies have influenced performance. Analyze emerging medical cost trends, understand patterns, draw conclusions and provide overviews to tell the story of emerging financial results/profitability for a specific product line. Will include identifying medical and pharmacy cost trend drivers, including but not limited to, impacts from clinical programs, contracting changes, provider network changes, geographical variation, medical cost initiatives and underlying population health. Identify opportunities for potential cost savings/revenue enhances/profitable growth opportunities. 

 Benefits

Benefits are effective day-one (for .45 FTE and above) and include:

  • Competitive salaries<\>

  • Full medical, dental and vision insurance<\>

  • Flexible spending accounts (FSAs)<\>

  • Free wellness programs<\>

  • Paid time off (PTO)<\>

  • Retirement plans, including matching employer contributions<\>

  • Continuing education and career development opportunities<\>

  • Life insurance and short/long term disability programs<\><\>

     

    About New Mexico

    New Mexico's unique blend of Spanish, Mexican and Native American influences contribute to a culturally rich life>Santa Fe's artists, and you get an eclectic mix of people, places, and experiences that make this state great.

     

    Cities in New Mexico are continually ranked among the nation's best places to work and live by Forbes magazine, Kiplinger's Personal Finance, and other corporate and government relocation managers like Worldwide ERC.

     

    New Mexico offers endless recreational opportunities to explore and enjoy an active life>

     

    AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke-free campuses.


    SS456

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!