Director, Health Value Insights - HYBRID (PA/NJ/DE)

Blue Cross and Blue Shield Association-posted 4 months ago
Full-time • Senior
Hybrid • Philadelphia, PA
Religious, Grantmaking, Civic, Professional, and Similar Organizations
Resume
Match Score
Upload and Match ResumeTrack Jobs with Teal

The Healthcare Value Optimization (HVO) team partners with key business stakeholders to identify, evaluate, and implement strategic initiatives aimed at bending the medical cost curve, mitigating/avoiding emerging cost drivers, and supporting enterprise-wide P&L objectives-including membership growth, competitive positioning, margin expansion/diversification, and administrative cost efficiency. Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together we will achieve our mission to enhance the health and well-being of the people and communities we serve. As a senior leader within this team, the Director of HVO Enablement and his/her team will work collaboratively with HVO and other business leaders in the strategic direction, execution, and impact of medical cost optimization initiatives across the organization. This role requires a high degree of cross-functional collaboration, analytical rigor, and executive-level communication.

  • Define and lead the enablement strategy for medical cost savings initiatives, ensuring alignment with enterprise goals and stakeholder priorities.
  • Direct and coordinate multi-disciplinary teams-including HVO analysts, Informatics, Clinical, Actuarial, and Business SMEs-to evaluate and size opportunities for medical cost reduction.
  • Cultivate strong relationships with senior leaders across the organization to ensure alignment, manage expectations, and drive adoption of cost optimization strategies.
  • Oversee the development of robust analytical frameworks and specifications, ensuring clarity, accuracy, and relevance to business objectives.
  • Translate complex data into strategic insights and executive-level presentations that inform decision-making and drive consensus across business units.
  • Provide end-to-end oversight of cost savings initiatives-from opportunity identification through final validation and reporting-ensuring timely delivery, quality assurance, and continuous improvement.
  • Lead strategic discussions with internal and external stakeholders to review findings, refine approaches, and explore new opportunities for value optimization.
  • Partner with Actuary, Contracting, and Finance to validate and finalize savings estimates.
  • Monitor post-implementation performance to assess actual versus projected impact.
  • Evaluate potential provider abrasion and material harm exposure to ensure initiatives are sustainable and aligned with provider relations strategies.
  • Lead exploratory analyses to uncover emerging trends, competitive insights, and benchmark comparisons that inform future cost containment strategies.
  • Serve as a strategic advisor and data expert to business units including Provider, Clinical, CFID, Pharmacy, Service Ops, Marketing, Sales, Finance, and Actuary.
  • Bachelor's degree in Business, Health Economics, Public Health, Data Science, or a related field required.
  • Master's degree (MBA, MPH, MHA, or equivalent) strongly preferred.
  • Minimum of 10 years of progressive experience in healthcare strategy, analytics, or value-based care.
  • Strong understanding overall health insurance with exposure to utilization management, analytics, contracting, policy, and provider communications.
  • Deep understanding of healthcare data (claims, clinical, pharmacy, provider).
  • Exceptional analytical and critical thinking skills across varied health care data types and scenarios.
  • Proficiency in data analysis tools (e.g., Excel, SQL, SAS, Tableau) and ability to translate data into actionable insights.
  • Exceptional ability to lead and influence across matrixed organizations.
  • Strong executive presence and communication skills, with experience presenting to senior leadership and external stakeholders.
  • Demonstrated success in partnering with departments such as Actuary, Contracting, Clinical, Informatics, Finance, and Sales.
  • Hybrid work model allowing remote work 2 days a week.
  • Work must be performed in the Tri-State Area of Delaware, New Jersey or Pennsylvania.
Track Jobs with Teal

Job Search Resources

•
Resume Builder
•
Resume Examples
•
Cover Letter Examples

Tools

Career Hubs

Guides

Company

© 2024 Teal Labs, Inc
Privacy PolicyTerms of Service