Director of Medical Economics

Job Locations US-MA-Boston | US
Job Post Information* : Posted Date 1 week ago(11/22/2021 9:18 AM)
ID
2021-1637
# of Openings
1
Career Area
Management

Overview

Director of Medical Economics

 

This is a fulltime opportunity. 

 

Job Location: Boston, MA;  or will consider remote option

 

Novocardia is on a mission to empower clinicians across the United States to consistently deliver higher-quality, prevention-focused, patient-centered care, and enable clinicians to be rewarded for focusing on these services for their patients, and delivering care now that avoids more advanced disease down the line.  

 

We are seeking a talented and experienced individual to join our growing team as Director of Medical Economics.  This role affords a singular opportunity to work closely with a world-class team to help build a disruptive, mission-driven, physician-led clinical delivery organization from the ground up! 

 

Chronic disease is the dominant cause of avoidable healthcare spending and death in the United States and worldwide.  Fortunately, much of this disease burden and associated spending is potentially avoidable through delivery of more proactive, prevention-focused care.  Our founding team has decades of experience in clinical medicine, payer and provider leadership, government, data science, and clinical operations.  We are deeply passionate about improving care quality, and providing more Americans with access to great, evidence-based chronic disease care. We are also deeply committed to building more sustainable and durable payment models for this care – models that reward clinicians for delivering the right care, in the right place, at the right time.  

  

We are looking for high integrity, mission-oriented people who are passionate about improving the quality and value of chronic disease care in America, excited to join a dynamic, rapidly-growing, and diverse team, and want to build a disruptive, world-class business.  We are humble, ambitious, learning-oriented, focused on execution, and all in on this venture and vision.  Come join us!

 

 Overview 

 

The Director of Medical Economics will be a critical member of a fast-paced, interdisciplinary team focused on using clinical and health insurance claims data to evaluate patterns related to quality and costs of care across geographic regions, clinical practices and hospitals, individual providers, and patients. This role will focus on analysis, modeling and design associated with FFV contracts and programs, and will engage directly with payers and providers as the face of Novocardia’s value-based analytics team. Through analytical and strategic rigor, this role will also help guide where we focus our efforts to improve quality, reduce total costs of care, and create additional value for ourselves, our patients, and our payor and provider partners.

Responsibilities

 

  • Work with the SVP, Operations and the contracting and value-based partnerships team to design and model FFV agreements with risk-bearing entities
  • Develop and oversee performance reporting and analytics models tied to FFS and FFV agreements, and develop insights and recommendations to help guide improvements in practice performance and contract design
  • Attend external facing meetings with risk-bearing entities and serve as Novocardia’s subject matter expert on FFV analytics and performance
  • Partner with the SVP, Operations and the contracting and value-based partnerships team to refine FFV contracting and partnership strategies
  • Conducts analysis of utilization data to ensure achievement of revenue, medical expense and gross margin goals.
  • Conducts detailed analysis of program utilization, identifying issues or opportunities that can improve performance.
  • Supports the development of effective medical cost management initiatives through monitoring and reporting the return on investment of these programs.
  • Consistently provides optimal customer service to all internal and external customers.
  • Measure the effectiveness of internally developed medical management initiatives.
  • Establishes sound cost savings calculations and methodologies, intended for internal and external analysis purposes.
  • Assists the data warehouse development team in prioritizing development work consistent with achieving company goals.
  • Respect and maintain HIPAA confidentiality guidelines.

Qualifications

  • Bachelor’s degree required with an emphasis placed on degrees in Economics, Computer Science, Statistics, and Math, or equivalent work experience in these disciplines.
  • Master’s degree in quantitative field is preferred.
  • At least 5 years of recent healthcare data analytic experience (ideally at a healthcare delivery organization, particularly a clinical delivery organization) involving clinical and insurance claims as well as extensive knowledge of CPT, ICD-10, DRG, and NDC codes.
  • Previous experience working with cardiology data is strongly preferred.
  • Must have knowledge of medical loss ratio calculations and financial models.
  • Experience with Excel spreadsheets and other office productivity applications used to share and present data analytic results.
  • Ability to understand and work with a variety of data formats to create graphs, tables, charts, and figures.
  • Outstanding organizational abilities with the ability to simultaneously juggle several complex projects.
  • Strong written and verbal communication skills, including the ability to summarize data analytic results for technical and non-technical audiences.
  • Resourceful and assertive and can leverage resources across the organization to get things done and asks for help and clarification when it is needed.
  • Must be able to work independently and demonstrate initiative as well as problem-solving skills within a fast-paced, ever-changing, start-up environment.
  • Committed to being a true team player; excited to roll up sleeves, dig in, and get work done with colleagues to help the company grow and succeed.
  • Acts with honor, integrity, and a high level of professionalism.
  • Excited to join a dynamic, high-integrity, mission-oriented, early-stage start-up company that is focused on improving care quality and building value-based reimbursement models.

 

 

Novocardia provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to religion, race, creed, color, sex, sexual orientation, alienage or citizenship status, national origin, age, marital status, pregnancy, disability, veteran, or military status, predisposing genetic characteristics or any other characteristic protected by applicable federal, state, or local law. 

 

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