Manager, Medical Economics

Site: Mass General Brigham Health Plan Holding Company, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are at the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage. Our work centers on creating an exceptional member experience – a commitment that starts with our employees.

Responsible for overseeing and managing the financial analysis, modeling, and reporting activities related to healthcare costs, utilization, and outcomes. This role requires a deep understanding of healthcare economics, reimbursement methodologies, data analytics, and business strategy.

Essential Functions

• Develop and manage the medical economics strategy, ensuring alignment with organizational goals and objectives.
• Analyze and interpret healthcare claims, utilization patterns, and cost data to identify trends, opportunities for cost savings, and performance improvement.
• Conduct complex financial modeling and forecasting to assess the financial impact of healthcare initiatives, policy changes, and reimbursement strategies.
• Collaborates with internal stakeholders, including finance, actuarial, clinical, product, and network management teams, to design and evaluate population-based health interventions and value-based payment models.
• Leads the development of analytical tools, dashboards, and reports that effectively communicate medical economics insights and recommendations to senior leadership.
• Stays current with healthcare industry trends, regulatory changes, and emerging reimbursement models to inform strategic decision-making.
• Drives the development and implementation of cost containment strategies, medical cost analytics, and performance improvement initiatives.
• Collaborates with data management and IT teams to ensure the availability, accuracy, and integrity of medical economics data and reporting systems.

Qualifications

Education Bachelor’s Degree required and Master’s Degree preferred (experience can be considered in lieu of a degree)

Experience

• At least 8-10 years of experience in healthcare economics, financial analysis, or a related field, preferably within a healthcare setting, required.
• At least 5-7 years of experience in a supervisory or management role required.
• Experience working for another healthcare payer highly preferred.
• Experience working with regulators highly preferred.

Knowledge, Skills, and Abilities

• Strong knowledge of healthcare reimbursement methodologies, payment models, and industry regulations (e.g., Medicare, Medicaid, Commercial insurance).
• Demonstrated experience in healthcare data analysis, including claims data, utilization metrics, and cost drivers.
• Proficiency in SQL, SAS, or other data analysis tools.
• Proven ability to develop financial models, conduct cost-benefit analysis, and perform forecasting.
• Strong strategic thinking and business acumen, with the ability to translate complex data into actionable insights and recommendations.
• Proficient in using data visualization tools (e.g., Tableau, Power BI) to present complex information in a clear and concise manner.
• Exceptional communication and presentation skills, with the ability to effectively convey complex concepts to both technical and non-technical stakeholders.

Working Conditions

This is a remote role that can be done from most US states Monday through Friday eastern business hours required Remote workdays require a stable, secure, quiet, and HIPAA-compliant workspace. This will be confirmed via Microsoft Teams video for all employees.

• Remote Type
• Remote Work Location 399 Revolution Drive
• Scheduled Weekly Hours 40
• Employee Type Regular Work Shift Day (United States of America)
• Pay Range $117,707.20 - $171,204.80/Annual
• Grade 8

In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth.

8925 Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at .

Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People‑Focused, half Performance‑Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

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Mass General Brigham is a passionate, welcoming community where minds meet caring hearts. Come be a part of the world’s most powerful force in medicine, where every role is important in changing lives. Our history includes New England hospitals founded over 200 years ago, some of the first and most prestigious hospitals in the world. Built on the legacy of two leading academic medical centers, we’re more than a system—we’re leaders in the practice of medicine. Mass General Brigham is committed to serving the community. We are dedicated to enhancing patient care, teaching and research, and taking a leadership role as an integrated health care system. We recognize that increasing value and continuously improving quality are essential to maintaining excellence.