At Blue Cross and Blue Shield of Nebraska, we are a mission-driven organization dedicated to championing the health and well-being of our members and the communities we serve.
Our team is the power behind that promise. And, as the industry rapidly evolves and we seek ways to optimize business processes and customer experiences, there’s no greater time for forward-thinking professionals like you to join us in delivering on it! As a member of Team Blue, you’ll find purpose, opportunities and the support you need to build a meaningful career and make a powerful impact in our community.
Candidates applying to this position may be hybrid or remote and can live in one of the following states: Florida, Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, and Texas.
The Vice-President of Healthcare Economics is a transformational leader who can balance operational excellence with innovation. This leader must deliver measurable affordability results today while designing the next generation of healthcare value creation. This position is the owner of medical cost analytics, accountable for explaining what drives healthcare cost trend, and leading the affordability agenda to respond to it. Success also requires envisioning and building a future in which Blue Cross and Blue Shield of Nebraska (BCBSNE) moves beyond being a payer of claims to becoming a trusted orchestrator of health, proactively guiding members towards better outcomes, improved experiences, and more affordable care.
What you'll do:
- Cost Management & Affordability Strategy: Design and lead enterprise strategies to manage total cost of careand affordability, directly supporting BCBSNE's broader enterprise priorities. Direct analytics for trend,forecasting and provider economics across all lines of business, and partner with actuarial, finance, marketsegment leaders, and network and value-based care to inform pricing, contracting, and value-based strategy.Lead the trend and affordability committee.
- Health Econ Strategy: Lead the population health analytics function, stratifying populations by cost, condition,and risk to identify actionable cost and utilization drivers. Develop affordability strategies leveraging predicativerisk identification and personalized member engagement. Work collaboratively with the Chief Medical Officerand leaders of medical and pharmacy management to quantify opportunities and outcomes. Establish consistentmethods to measure utilization, unit cost, acuity and trends.
- Identify Emerging Risks and Savings Opportunities: Establish affordability targets, measurement frameworksand reporting. Translate data and analytics into strategic recommendations for internal and external audiences,including BCBSNE customers, the Executive Leadership Team, and Board-level audiences.
- Team Leadership: Lead and develop teams of analysts and economists supporting population health and cost-strategy work, including provider economics, unit-cost modeling, contract term evaluation, fee schedule impactanalysis.
- Partnerships that Drive Action and Outcomes: Partner with market segment leaders and business functionowners to translate findings into accountable action plans. Drive action plans to measurable outcomes forspecific populations and for the enterprise.
- Innovation and Future-State Affordability: Design and test new leading indicators and models that proactivelyinfluence health outcomes before high-cost events occur. Advance BCBSNE in predicative analytics, event-driven health management, behavioral economics and personalized interventions.
To be considered for this position, you must have:
- Advanced degree or proven experience in health economics, public health, biostatistics, or a related field.
- 8 to 12 or more years of experience in health care economics, population health analytics, or health plan strategy.
- Demonstrated people-leadership experience managing analyst or economist teams.
- Strong track record translating complex data into executive-level strategy and recommendations.
- Experience working across fragmented data environments.
- Experience working cross-functionally and leading through influence in a matrix-style environment.
An equivalent combination of education and experience may be substituted for this requirement.
The ability to meet or exceed the attendance and timeliness requirements of their departments.
The ability to work well in a team environment and be capable of building and maintaining positive relationships with other staff, departments, and customers.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other duties may be assigned.
The strongest candidates for this position will also possess:
- Experience designing or implementing event-driven healthcare models
- Experience with behavioral economics and incentive design
- Track record leading healthcare transformation initiatives
- Demonstrated thought leadership regarding the future of healthcare financing and consumer engagement
- Payer-side experience, ideally with ACO or value-based care strategy exposure.
- Experience with CMS Innovation Center models and provider risk arrangements.
- Familiarity with integrating non-traditional data sources, such as social determinants, behavioral, and retail data, into population health models.
Learn more about what makes BCBSNE such an exceptional place to work by visiting NebraskaBlue.com/Careers.
We strongly believe that diversity of experience, perspective and background will lead to a better workplace for our employees and a better product for our customers and members.
