Director, Medical Cost Management

1 Month ago • 10 Years + • $150,000 PA - $185,000 PA

Job Summary

Job Description

Well is seeking a Director of Medical Cost Management to lead strategy and execution of cost management initiatives, focusing on reducing medical and pharmacy costs for self-insured employers. This role involves using data-driven approaches to identify and implement interventions, collaborating with internal teams, and communicating strategies and results to stakeholders. Key responsibilities include owning the cost management strategy, proposing savings targets, designing interventions using data analysis (claims data, CPT, ICD-10 codes), and collaborating with various teams like Member Services, Operations, Marketing, Clinical, Data Science, and Product.
Must have:
  • 10+ years of experience in medical/pharmacy cost management
  • Experience with self-insured employers
  • Strong data analysis and interpretation skills
  • Proficiency in SQL, R, Python, or Stata
  • Excellent communication and presentation skills
  • Ability to collaborate with stakeholders
  • Financial acumen in healthcare cost management
Good to have:
  • Actuarial experience is helpful but not required
  • Experience with data visualization software
Perks:
  • Bonus potential
  • Benefits

Job Details

Company: The mission of Well (https://www.well.co/) is to transform healthcare through our unique impact on our members' health and happiness. We do this through our differentiated consumer experience and world-class data and analytics engine that drive engagement and behavior change. Our product — a consumer health engagement platform — integrates concierge services, behavioral health, telemedicine, care management and wellness services to drive sustained engagement, lower costs and improve the health of members. In addition to our product, we know our team makes us unique. We’re a highly diverse and engaged organization whose employees are passionate about the mission of the company and whose management is passionate about the employees. We promote an employee- and member-centric culture with generous benefits, which you can learn more about here: https://www.well.co/careers.

Position Title: Director, Medical Cost Management

Reporting To: Chief Operating Officer

Location: Chapel Hill, NC; Newton, MA; New York, NY; Minneapolis, MN; Remote considered

Compensation Information: $150,000-$185,000 (Director 2 - Senior Director 1), depending on qualifications, plus bonus potential and benefits

Position Summary:

The Director of Medical Cost Management will be responsible for leading the strategy and execution of cost management initiatives at Well. This role will focus on identifying opportunities to reduce medical and pharmacy costs for Well's clients, with a focus on self-insured employers. The Director will use data-driven approaches to design and implement targeted interventions, collaborate with internal teams, and communicate cost management strategies and results to both internal and external stakeholders including growth prospects.

Responsibilities:

  • Own and finalize strategy for medical and pharmacy cost management
  • Propose cost savings targets for Well on a client-by-client, population-by-population basis
  • Use data to identify and design targeted interventions to achieve cost targets
  • Collaborate with cross-functional colleagues (e.g., Member Services, Operations, Marketing, Clinical, etc.) to deploy cost interventions.
  • Serve as the spokesperson for external and internal communication/storytelling around cost management (for clients, growth prospects, internal/All Hands); support strategic cost conversations with clients and growth prospects
  • Collaborate with and provide input to health outcomes & business intelligence teams on ROI, outcomes calculations, and cost savings forecasts/projections by client including tracking and reporting on performance against savings goals over time
  • Collaborate with and provide input to Data Science team on cost benchmarking, risk prediction, and other cost-related models to consider building or using at Well
  • Provide input to the Product team on the roadmap for cost savings-related features, Member Services staff (Well Guide) tools, etc.
  • Take personal responsibility for keeping all Well systems and data, including sensitive member data, secure and safe, according to Well data and security policies and HIPAA guidelines

Preferred Qualifications:

  • 10+ years of experience with medical and pharmacy cost-related work, ideally working with self-insured employers to identify and act on cost savings opportunities; actuarial experience is a helpful but not required 
  • Data analysis and interpretation: Strong ability to analyze complex healthcare data (e.g., administrative claims data including CPT and ICD-10 codes, cost data) to identify cost-saving opportunities, trends, and areas for intervention
  • Proficiency in tools like SQL, R, Python, Stata and data visualization software
  • Strategic and consultative skills: Ability to develop and execute cost management strategies that align with organizational goals and address the specific needs of clients or member populations
  • Communication and presentation skills: Excellent verbal and written communication skills to effectively convey cost management strategies, findings, and recommendations to a variety of audiences
  • Stakeholder management and collaboration: Proven ability to build relationships and collaborate effectively with internal and external stakeholders
  • Financial Acumen: Understanding of budgeting, forecasting, and financial analysis related to healthcare cost management

Additional Job Information

Well is on a mission to redefine the healthcare experience. This is an opportunity to re-shape healthcare for America. We are developing solutions to improve the quality and affordability of healthcare. We welcome team members who are passionate about that mission. We embrace diversity and are committed to building an inclusive team.

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