Director Medical Economics

Information Services or Technology
21003470 Requisition #
218 Total Views

Please note: Southwestern Health Resources Clinically Integrated Network (SWHR CIN) is an affiliated company of Texas Health and UT Southwestern.  If hired for this position, you will become a SWHR CIN employee rather than a Texas Health or UT Southwestern employee. 

Southwestern Health Resources Clinically Integrated Network, SWHR CIN, is hiring for a Director Medical Economics.  This position will lead the Medical Economics department for Southwestern Health Resources by designing and overseeing integration of data analytics and modelling necessary for supporting the overall executive objectives and strategies.


Location: Farmers Branch, TX


Work Schedule  

• Full time, day shift 


Job Description 

Responsible for the strategic design and development of tools to measure the leading cost drivers to support the integrated decisions needed for operations, clinical, and financial executive leadership teams

Oversees advanced analytics to enable rich insight from multiple external data sets, scenario modelling and simulations to drive the strategic vision to improve financial performance tied to medical and pharmacy cost trends.

Monitors SWHR and market cost data and trends to determine potential external impacts or opportunities for SWHR in its full risk arrangements and other gainshare arrangements. Supporting the continuum of analytics needed for senior leadership from financial, operations and clinical areas.

Oversight and monitoring the key contractual payor levers by the continual monitoring of SWHR subset of key leading cost drivers continues to support the most optimal contractual performance given various contractual levers, stop loss threshold, DOFR exclusions, and shared savings/loss thresholds.

Develop outcome-based metrics to monitor and identify program effectiveness encompassing the financial expenses, quality outcomes, patient and provider satisfaction results, operational performance, and contractual performance needed to inform senior leadership on evaluation of program.

Supporting financial return calculations for proposed quality and risk initiates, post-acute models, other network operation opportunities.

Build key metrics and model designs for third-party risk arrangements needed to facilitate improvements and or/expansion of programs such as complex pharmacy spend, remote monitoring, hospitalist programs etc.

Strong partnership with the Business Intelligence and Analytics teams under the Chief Data Insight and Innovation Officer to ensure data standardization

Supporting and developing the analysis and data modeling needed to support the Medical Management Committees


The ideal candidate will possess the following qualifications 


Bachelor's Degree in Business or Finance required
Master's Degree in Business or Finance preferred

8 years progressively responsible, related experience to include at least three (3) years in supervisory capacity required.  *** Experience with Accountable Care Organizations (ACO) models and contracts is very highly preferred ***

Works requires expert knowledge of advanced data science and complex analytical skills
Work requires understanding of Accountable Care Organizations, models, and contracts.
Work requires demonstrated database, analytical, and presentation skills.
Work requires independent, prudent problem solving.
Work requires good interpersonal, customer service, supervisory, organizational, and leadership skills.
Work requires ability to review, develop, recommend, and implement policies.
Work requires exercise of considerable judgment and great attention to detail.
Must be able to communicate frequently and openly with leadership team to produce environment that is collaborative and high-performing

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