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Salary
$90k - $137k
Experience
6+ Years

This position is archived. Acturhire has detected that this position is no longer accepting applications.

Role Summary

Senior health-plan Medical Economic Manager in Albuquerque, NM. You will act as the financial expert for product lines (Commercial, Medicare, Medicaid), supporting pricing, identifying medical and pharmacy cost drivers, and reviewing monthly reserve (IBNR) analysis. The role partners cross-functionally with pricing, provider contracting, clinical ops, and finance.

Key Requirements

  • 6 years healthcare industry experience in medical economics/product performance
  • Bachelor’s degree in healthcare, accounting, finance or quantitative field
  • Solid knowledge of health plan operations and provider contracting
  • Experience with ICD9/10, CPT, HCPCS, MS-DRG, PMPM metrics
  • Strong Excel/Access and BI tooling experience (e.g., Business Objects)

Skills & Domain

ToolsExcelAccessPowerPointOther_BI_Tool
DomainMedical economics and product performance analysisHealth plan operations including population health and utilization managementProvider contracting and value-based reimbursement experienceFamiliarity with ICD9/10, CPT, HCPCS, MS-DRG coding and PMPM metricsReserve analysis (IBNR) and trend identification

Job Overview

Salary
$90k - $137k
Experience
6+ Years

Ideal Candidate Profile

Ideal for a manager-level medical economics professional with 6+ years in health plan analytics, experience across Commercial/Medicare/Medicaid product lines, and strong Excel and BI skills to support pricing and reserve analysis.

Benefits

Health InsuranceDental InsuranceVision InsuranceShort/Long Term DisabilityLife InsuranceWellness Program

Medical Economic Manager

Presbyterian Healthcare Services

Closed
Health/Insurer/Manager Level
Presbyterian Healthcare Services

Medical Economic Manager

Presbyterian Healthcare Services

Cooper, United States · Onsite · 9mo ago

Commercial Employer HealthMedicare AdvantageMedicaid
Closed

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