Director, Health Services Research & Evaluation

Primary Duties
The Director, Health Services Research & Evaluation provides health services research and analytical leadership to the Health Plan Division, in partnership with corporate Informatics and Quality Management. The Director is responsible for overseeing the department by developing annual departmental specific goals and objectives and overseeing all project plans, action plans and budgets to ensure goals are met, as well as providing oversight, support and mentoring to department staff. The Director will strategically lead the department by staying apprised of industry best practices in all functional areas of the department and proposing and planning new research and analytical services to meet the needs of population health programs, provider reimbursement and network design, client expectations, marketing strategies and medical cost and quality management. In addition, the Director will play an integral role in promoting collaboration with the rest of the organziation and overseeing standard and adhoc internal and external analysis and reporting.

Date of Listing
02/07/2008

Position Type
Full-time

Schedule
M-F

Required Education
Masters degree in public health, health administration, biostatistics, epidemiology, health services research, medical sociology or related field. Doctorate degree preferred.

Minimum Qualifications
5 years experience managing a department or section of a department including multiple teams, leadership positions and front line positions required -3 years of that experience must be in a managed care setting, preferably in commercial and Medicare Advantage managed care environments. Experience overseeing quality of care and medical cost trending and evaluation, return on investment estimations, program outcomes and evaluation required. Experience with predictive modeling and methodologies to support case management, chronic care management, and/or wellness and health promotion strongly preferred. Experience analyzing a variety of data including medical and pharmacy claims, laboratory results, health risk appraisal data, survey data, etc. is required. Experience with electronic health record and clinical practice disease registry data is preferred. Experience reporting on performance measurement at the health plan, product, customer, and provider level strongly preferred. Experience with NCQA HEDIS reporting is preferred.

Position Available Date
02/07/2008