Senior Director, Healthcare Economics

Inland Empire Health Plan•Rancho Cucamonga, CA

1d•$220,043 - $302,536•Hybrid

About The Position

Reporting to the Chief Financial Officer, the Senior Director of Healthcare Economics provides strategic and operational leadership for the economic analysis and financial performance optimization of IEHP’s healthcare business, including medical and non-medical costs, revenue, and other financial drivers. The Senior Director collaborates closely with Finance, Actuarial Services, Clinical Operations, and Provider Network teams, and other senior leadership to understand the economic drivers of each line of business, identify opportunities, and deliver actionable insights that promote cost-effective, high-quality care improve margin, affordability, operational efficiency, and overall program performance. This position includes full team oversight, administering hiring, terminations, performance reviews, and building a high-performing analytical team that supports IEHP’s mission and financial sustainability. The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Requirements

A minimum of ten (10) years of progressive experience in medical economics, healthcare financial analytics, health plan forecasting, or related quantitative health financial functions
Experience leading analytical and financial teams, including hiring, coaching, performance management, and team development
Proven ability to collaborate across Finance, FP&A, Clinical Operations, Provider Network
Bachelor’s degree in a quantitative, financial, or health‑related field (e.g., Economics, Finance, Public Health, Health Administration, Statistics, Mathematics, Data Science) from an accredited institution
Must have a valid California Driver’s license
Advanced knowledge and in-depth understanding of: Principles of medical economics, healthcare financial management, and population health cost analytics
Industry standard forecasting, trend analysis, and cost modeling methodologies used by health plans
Utilization management concepts, care model design, and drivers of high cost healthcare utilization
Best practices in financial planning & analysis (FP&A), including budgeting, variance analysis, and long range financial planning
Standard practices for organizational change management when implementing cost saving initiatives
Advanced proficiency in: Interpreting and analyzing large healthcare datasets, including claims, encounter, utilization, risk adjustment, and quality data
Financial modeling tools, including Excel
Evaluating cost saving initiatives and calculating financial impact using ROI, cost benefit analysis, and scenario testing
Building and leading analytical teams using workflow management tools, training frameworks, and coaching practices
Written and verbal communication skills, including the ability to translate complex analytics into clear insights for executive audiences
Demonstrated ability to: Lead change management efforts tied to cost reduction strategies, operational optimization, and organizational improvement initiatives
Translate complex financial, clinical, and analytical concepts into clear, actionable insights for executives, clinical leaders, and operational teams
Collaborate across Finance, FP&A, Clinical Operations, Provider Network, and Actuarial teams to execute cross functional initiatives

Nice To Haves

Experience in Medicaid managed care or other publicly sponsored health plan environments
Experience leading enterprise financial planning or overseeing FP&A activities (budgeting, forecasting, long range planning)
Experience implementing operational or financial improvements through cross departmental change management efforts
Experience driving measurable improvements in medical cost trend, utilization patterns, and provider performance
Master’s degree in health economics, Public Health (MPH), Health Administration (MHA), Economics, Statistics, Data Science, Healthcare Analytics, or related quantitative discipline. MBA is also acceptable

Responsibilities

Direct development and refinement of comprehensive healthcare economics framework covering medical and non-medical cost drivers, revenue streams, operational inputs, and market dynamics.
Identify and quantify performance gaps and opportunities across all business lines to improve margin, affordability, and long-term sustainability. Including but not limited to detailed trend impacts, utilization shifts as well as budget risks to support organizational financial as well as non-financial goals
Drive rigorous deep-dive analyses across medical and non-medical cost drivers, revenue streams, utilization patterns, and operational performance metrics.
Apply advanced diagnostic techniques to uncover the true underlying root causes behind emerging trends and performance issues.
Translate complex analytical findings into clear, actionable initiatives that guide operational improvements, cost‑reduction strategies, revenue optimization, and enterprise‑level decision-making
Provide full oversight for the Healthcare Economics team, including hiring, coaching, performance reviews, training, and workflow management.
Establish department goals, build analytical capabilities, and maintain high-quality standards for deliverables
Lead identification, evaluation, and execution and implementation of cost saving and margin-improvement initiatives across medical spend categories and administrative spend categories., including high cost claim management, care model optimization, provider incentive refinement, and avoidable utilization reduction.
Partners with Clinical Operations, Provider Network, and Finance, and Actuarial Services to evaluate cost drivers and execute operationally to implement initiatives improvements
Design, maintain, and continuously support the enhancement of executive‑level dashboards that provide clear visibility into strategic initiative outcomes.
Deliver concise performance summaries, trend insights, and initiative progress reporting that highlight risks, opportunities, and recommended actions across the healthcare business
Conduct comprehensive financial evaluations of healthcare investments and enterprise programs, including ROI analysis, cost‑benefit assessment, and long‑term value measurement.
Assess strategic initiatives for financial viability, operational impact, and alignment with organizational goals.
Deliver clear, data‑driven decision support to senior leadership by translating complex financial and operational analyses into strategic recommendations that optimize affordability, quality, and enterprise performance
Perform any other duties as required to ensure Health Plan operations and department business needs are successful