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Role Summary

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HIGHLIGHTS

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.

JOB DESCRIPTION SUMMARY

Act as financial expert for Commercial, Medicare, and Medicaid product lines
Support pricing strategy and identify medical/pharmacy cost drivers
Review monthly reserve (IBNR) and advise on emerging trends
Work onsite at Reverend Hugh Cooper Administrative Center in Albuquerque, NM
Requires 6+ years in medical economics/health plan analytics

DOMAIN EXPERTISE

Medical economics and product performance analysis
Health plan operations including population health and utilization management
Provider contracting and value-based reimbursement experience
Familiarity with ICD9/10, CPT, HCPCS, MS-DRG coding and PMPM metrics
Reserve analysis (IBNR) and trend identification

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)

TECH STACK

Excel
Access
PowerPoint
Other_BI_Tool

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Role Summary

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HIGHLIGHTS

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.

JOB DESCRIPTION SUMMARY

Act as financial expert for Commercial, Medicare, and Medicaid product lines
Support pricing strategy and identify medical/pharmacy cost drivers
Review monthly reserve (IBNR) and advise on emerging trends
Work onsite at Reverend Hugh Cooper Administrative Center in Albuquerque, NM
Requires 6+ years in medical economics/health plan analytics

DOMAIN EXPERTISE

Medical economics and product performance analysis
Health plan operations including population health and utilization management
Provider contracting and value-based reimbursement experience
Familiarity with ICD9/10, CPT, HCPCS, MS-DRG coding and PMPM metrics
Reserve analysis (IBNR) and trend identification

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)

TECH STACK

Excel
Access
PowerPoint
Other_BI_Tool

Job Overview

Salary

$90k - $137k

Years of Experience

6+ Years

Work Type

Permanent

Full Time

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

Shortlist Forming

Closing Soon

47d

47 days ago

Strategy: Speed over Perfection

By Day 21, visibility drops significantly. Recruiters are focusing on existing candidates.

"Don't wait for a cover letter. The requisition could close tomorrow. Apply now."

Job Overview

Salary

$90k - $137k

Years of Experience

6+ Years

Work Type

Permanent

Full Time

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

Shortlist Forming

Closing Soon

47d

47 days ago

Strategy: Speed over Perfection

By Day 21, visibility drops significantly. Recruiters are focusing on existing candidates.

"Don't wait for a cover letter. The requisition could close tomorrow. Apply now."

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