Vice President of Medical Economics

Remote: 
Full Remote
Contract: 
Work from: 

Offer summary

Qualifications:

Master's degree required., Three years of experience in financial analysis and medical economics., Experience with SQL, PowerBI, Excel, Azure, or Access is essential., At least two years of supervisory experience with a team..

Key responsibilities:

  • Lead the Medical Economics department and manage strategic trend identification.
  • Analyze healthcare utilization and financial data to inform business planning.
  • Develop cost models and key performance indicators for performance management.
  • Support rate negotiations with the State and oversee encounter submission processes.

Trillium Health Resources logo
Trillium Health Resources Insurance SME https://www.trilliumhealthresources.org/
501 - 1000 Employees
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Job description

Pay Plan Title: Senior Director

Working Title: Vice President of Medical Economics

Cost Center: 42/Business Administration

Position Number: 81321

FLSA Status: Exempt

Posting Salary Range: $95,481 - $127,308

Office Location: Remote within North Carolina

POSTING DETAILS:

Make an Impact  

Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) that manages serious mental health, substance use, traumatic brain injury, and intellectual/developmental disability services in North Carolina. Serving in 46 counties, we help individuals and their families strengthen well-being and build foundations for a healthy life.

Join our team as we empower others to live their best lives by providing access to quality healthcare. We offer a challenging, engaging work environment where staff take home more than a paycheck. Every day, we see the results of our dedication – in the smiles of children on our accessible playgrounds and in the pride on the face of an adult cooking a meal for the first time. Working at Trillium Health Resources is more than just a job; it is an opportunity to make a direct impact on the communities we serve.

At Trillium, we know that empowering others begins with supporting and developing our team. That’s why we offer competitive benefits and work-from-home flexibility so that our employees thrive outside of the office. We’re also committed to building a diverse, inclusive culture where all employees have the potential to grow professionally and personally.

What We’re Looking For

Trillium Health Resources has a career opening for Vice President of Medical Economics to join our Finance Team. This position provides leadership and management for the Medical Economics department. The Vice President of Medical Economics is responsible for safeguarding the agency’s resources through strategic trend identification, monitoring medial cost trend, issue resolution and technical solutions. This position may make independent decisions on a regular basis.

Start your Trillium Career by applying today!

 

On a typical day, you might:

  • Plan to improve future business planning.

 

  • Lead planning and development of complex operational, healthcare, and statistical analysis.

 

  • Apply analytical best practices to identify key drivers and sub-optimal performance.

 

  • Develop and validate cost model outcomes, savings modeling assumptions, and Return on Investment (ROI) recommendations.

 

  • Analyze and report on health care utilization, operational, and financial data.

 

  • Develop and maintain key performance indicators to enable performance management and accountability with a focus on business line strategy, risk retention strategies, clinical analytics, and MLR monitoring.

 

  • Develop and maintain cost models for managing MLR and total cost of care.

 

  • Support rate negotiations with the State and Medicaid actuaries.

 

  • Direct oversight of the encounters submission and processes related to enhancing analysis, reconciliation, auditing, and reporting for encounter functions.

Employee Benefits:

Trillium knows that work/life balance is important. That’s why we offer our employees competitive benefits and flexibility that is second to none. Take a look at what we have to offer:

  • Typical working hours are 8:30am-5pm
  • A remote work option available for most positions
  • Health Insurance - no premium for employee coverage
  • Flexible Spending Accounts
  • Paid Time Off (PTO) of 24 days, plus 12 paid holidays within first year of employment
  • NC Local Government retirement pension. This is a defined-benefit retirement plan that will pay you a monthly amount upon retirement, for the rest of your life, with as little as five years of service. For more information, go to: https://files.nc.gov/retire/documents/files/Actives/LGERSHandbook.pdf
  • 401k with 5% employer match & immediate vesting
  • Public Service Loan Forgiveness Qualifying Employer

Qualifications: 

Education:

A Master’s degree is required.

 

Experience:

Three (3) years of experience in financial analysis and medical economics. Must include experience in one of the following areas: developing and writing code using SQL or experience with PowerBI, Excel, Azure, or Access.

 

Additionally, must have at least two (2) years of supervisory experience with two (2) more employees.

Preferred Experience:

SQL experience or other advanced analytics technology.

 

License/Certification:

Must have a valid driver’s license.

 

Location: 
 Remote within North Carolina.

Must reside in NC to be considered for remote status.

 

Deadline for application: Wednesday, June 11, 2025 at 11:59pm

 

To be considered for employment, all candidates are required to submit an application through ADP and upload a current resume.  Your resume must provide your level of education and detailed work experience, including: 

  • Employer Name
    1. Dates of service (month & year)
    2. Average number of hours worked per week
    3. Essential duties of the job as related to the position you’re applying for
  • Education
    1. Degree type
    2. Date degree was awarded
    3. Institution
  • Licensure/certification, if applicable

After submitting your application through our career center in ADP, your resume will be reviewed to ensure that your skills and experience meet the essential criteria for the role you have applied for.

You will be notified by HR on the status of your application as appropriate.  All applicants will receive a final email when the recruitment cycle for the position has closed.  

Join our Talent Community through our ADP career center to stay informed about positions you may qualify for. Remember to keep an update resume in the Talent Community profile. 

The diversity of the communities we serve is reflected in our employees. Trillium Health Resources is an Equal Employment Opportunity (EEO) employer.

Trillium Health Resources is a drug-free workplace. Candidates are required to pass a drug test as a condition of employment.

#Innovation   #Technology   #Careers   #NorthCarolina   #BehavioralHealth

Required profile

Experience

Industry :
Insurance
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Microsoft Excel
  • Decision Making
  • Communication
  • Problem Solving
  • Leadership

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