Vice President, Cost Management – Affordability
About The Position
The Vice President, Cost Management is the senior leader responsible for developing, implementing, and overseeing enterprise-wide affordability and cost-of-care management strategies. The role leads organizational efforts to identify, evaluate, implement, and monitor initiatives that improve healthcare affordability while maintaining quality outcomes and member access to care. The Vice President collaborates across Clinical Operations, Care Management, Utilization Management, Network Management, Population Health, Medical Economics, Finance, Pharmacy, and Executive Leadership to identify utilization and service cost trends, develop intervention strategies, establish financial targets, and ensure accountability for implementation and results. The position establishes an affordability framework that translates analytical findings into actionable initiatives, measurable savings opportunities, and sustainable financial outcomes.
Requirements
- Bachelor's degree and six years of experience in a government-sponsored healthcare program, managed care, healthcare operations, population health, medical economics, healthcare finance, utilization management, payment integrity, network management, affordability, or a related healthcare environment, including relevant experience in financial project management, healthcare data or trend analysis, healthcare economics, cost management, affordability management, financial project controls, payment integrity, financial modeling, or overseeing large-scale medical and behavioral healthcare expenditure targets and affordability initiatives.
- At least two years of experience supervising at least two employees is required with the bachelor's-degree pathway.
- Alternatively, a master's degree and three years of experience in the listed healthcare environments and areas of relevant experience, including at least two years supervising at least two employees.
- Valid driver's license.
- Must reside within the United States.
- Must be legally authorized to work in the United States without requiring employment sponsorship now or in the future.
Nice To Haves
- Master's degree in Business Administration, Healthcare Administration, Finance, Economics, Public Health, or a related field.
- Ten years of progressively responsible Medicaid managed care, Tailored Plan, LME-MCO, healthcare economics, medical economics, affordability management, healthcare finance, population health, utilization management, network management, or government healthcare experience.
- Experience leading enterprise trend-bending initiatives.
- Experience presenting to executive leadership.
Responsibilities
- Establish affordability goals and financial targets aligned with organizational objectives.
- Collaborate with operational leaders to develop intervention strategies that reduce unnecessary cost growth.
- Conduct deep-dive analyses to understand root causes of healthcare cost growth.
- Oversee development of financial impact assessments for affordability initiatives.
- Prepare executive-level reports, presentations, and recommendations.
- Develop, implement, and oversee enterprise-wide affordability and cost-of-care management strategies.
- Identify, evaluate, implement, and monitor initiatives intended to improve healthcare affordability while maintaining quality outcomes and member access to care.
- Identify utilization and service cost trends and ensure organizational accountability for initiative implementation and results.
Benefits
- Collaborative, mission-driven work environment.
- Competitive benefits and work-from-home options for most positions.
- Opportunities for professional growth in a diverse, inclusive culture.
- Flexible work schedules available for some positions with management approval.
- Health insurance with no premium for employee coverage.
- Flexible Spending Accounts.
- 24 days of paid time off plus 12 paid holidays in the first year.
- North Carolina Local Government Retirement Pension, a defined-benefit plan.
- 401(k) with 5% employer match and immediate vesting.
- Public Service Loan Forgiveness qualifying employer.
- Quarterly stipend for remote work supplies.
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What This Job Offers
Job Type
Full-time
Career Level
Executive
