Vice President, Medical Economics

Blue Cross Blue Shield of Massachusetts•Boston, United States•4mo ago

OnsiteCommercial Employer HealthPricing & RatingPredictive Modelling & MLBusiness Intelligence & Reporting

Role Summary

HIGHLIGHTS

Senior Health analytics leader (VP, Medical Economics) at a Boston-based insurer. Owns development of trend, pricing, and forecasting analytics, integrates medical and pharmacy insights, and leads market-facing plan and account reporting. Manages a team (3–5) and partners with actuarial, product, pharmacy, and senior leadership to inform pricing, reserving, and financial planning.

JOB DESCRIPTION SUMMARY

Lead medical expense trend analytics and business-case valuation for plan and accounts
Integrate medical and pharmacy insights and partner with actuarial pricing teams
Use advanced analytics, including machine learning/AI, for predictive tools
Manage a team of 3–5 leaders; executive-level role in Boston
Requires senior experience and advanced degree/FSA

DOMAIN EXPERTISE

medical economics
trend management and forecasting
provider and account informatics
pricing and financial planning
pharmacy analytics integration

KEY REQUIREMENTS

10+ years of health care experience including Medical Economics and trend management
Direct experience leading and managing staff required
BA/BS required; FSA, MBA or other advanced degree required
Demonstrated experience with advanced analytics / ML to inform medical cost drivers