Manager, Medical Economics - REMOTE

JOB DESCRIPTION

Job Summary
Responsible for leading the refinement, operationalization, and stewardship of enterprise healthcare datasets for Medical Economics use cases. This role focuses on transforming foundational enterprise data assets into trusted, business-ready datasets aligned to Medical Economics reporting, analytics, and operational workflows. The curation and enhancement of authorization data assets is an initial priority.

This role partners closely with Enterprise Information Management (EIM), Medical Economics, Reporting, and operational stakeholders to improve data quality, establish sustainable governance practices, and support scalable enterprise data solutions.

Essential Job Duties

• Data Curation & Stewardship: 
-    Lead refinement and operationalization of enterprise datasets for Medical Economics use cases
-    Establish and maintain business definitions, transformation logic, validation rules, and reconciliation processes
-    Identify and resolve data quality, consistency, and usability gaps across curated datasets
-    Drive continuous improvement of data assets to support evolving business needs
• Authorization Data Enhancement
-    Lead Medical Economics curation efforts for authorization data assets
-    Define and document business logic and operational interpretations required for Medical Economics workflows
-    Partner with EIM and upstream data owners to improve foundational data quality and alignment
-    Ensure curated authorization datasets are scalable, reliable, and analytically usable
• Team Leadership & Execution 
-    Manage and mentor Lead Analysts supporting data curation initiatives
-    Establish standards for documentation, validation, issue management, and operational support
-    Support prioritization and delivery planning across the team
• Cross-Functional Partnership
-    Serve as a liaison between Medical Economics, EIM, Finance, and operational stakeholders
-    Translate business pain points into actionable data improvement opportunities
-    Facilitate alignment on definitions, priorities, dependencies, and implementation sequencing
• Governance & Operationalization
-    Support governance processes for curated datasets
-    Maintain documentation for business rules, lineage, assumptions, and operational workflows
-    Promote transparency, consistency, and sustainable support models across data assets
• Coordinates with medical economics team to meet data analysis and database development needs.
• Reviews, evaluates, and improves business logic and data sources.
• Acts as a resource to team for medical economics/analysis related questions.
• Reviews medical economics analysis work products to ensure accuracy and clarity.
• Reviews regulatory reporting requirements and health plan project documentation.
• Maintains reporting service level benchmarks for enterprise information management (EIM) team.
• Represents medical economics department in cross-departmental and operational meetings. 
• Serves as liaison between EIM and medical economics for reporting needs.
• Collects, validates, analyzes, and organizes data into meaningful reports for leadership decision making, and designs, develops, tests and deploys reports to other end users for operational and strategic analysis.
• Creates reporting for strategic analysis, profitability, financial analysis, utilization patterns and medical management.
• Collaborates with and provides medical economics subject matter expertise for health plans and enterprise teams.
• Supports scoreable action item (SAI) initiative tracking to performance.

Required Qualifications

• At least 7 years of health care analytics and/or medical economics experience, preferably in claims processing environment and/or health care environment, or equivalent combination of relevant education and experience.
• At least 1 year of management/leadership experience.
• Bachelor’s degree in statistics, mathematics, economics, computer science, health care management or related field.
• Demonstrated understanding of Medicaid and Medicare programs or other health care plans.
• Analytical work experience within the health care industry (i.e., hospital, network, ancillary, medical facility, health care vendor, commercial health insurance, large physician practice, managed care organization, etc.)
• Familiar with relational database concepts
• Proficiency with retrieving specified information from data sources.
• Experience with building dashboards in Excel, Power BI, and/or Tableau and data management.
• Knowledge of health care operations (utilization management, disease manage