Vice President, Cost Management – Affordability

Accountabilities

Develop, implement, and oversee enterprise-wide affordability strategies and cost-of-care management initiatives aligned with organizational priorities.
Establish measurable affordability goals, financial targets, and performance indicators to monitor healthcare expenditure and improve financial sustainability.
Analyze healthcare utilization patterns, service costs, and financial trends to identify the root causes of rising expenditures and opportunities for improvement.
Collaborate with leaders across Clinical Operations, Care Management, Utilization Management, Network Management, Population Health, Medical Economics, Finance, and Pharmacy to design and implement cost-reduction strategies.
Identify opportunities to reduce unnecessary healthcare utilization and cost growth while maintaining high-quality outcomes and appropriate member access to care.
Oversee financial impact assessments, business cases, and financial modeling for proposed affordability initiatives, ensuring expected savings and outcomes are clearly defined.
Translate analytical findings into practical intervention plans, actionable recommendations, and sustainable cost management solutions.
Drive cross-functional execution and accountability, ensuring affordability initiatives are implemented effectively and deliver measurable results.
Monitor the financial and operational performance of cost management programs, assess progress against established targets, and recommend adjustments when necessary.
Prepare and present executive-level reports, financial analyses, strategic recommendations, and performance updates to senior leadership.
Lead and develop teams responsible for cost management and affordability initiatives, fostering collaboration, accountability, and continuous improvement.
Requirements:
Education and experience: Bachelor's degree with at least six years of relevant healthcare experience, or a master's degree with at least three years of relevant experience. Experience must include work in government-sponsored healthcare programs, managed care, healthcare operations, population health, medical economics, healthcare finance, utilization management, payment integrity, network management, affordability, or a related healthcare environment.
Financial and analytical expertise: Demonstrated experience in financial project management, healthcare data and trend analysis, healthcare economics, cost management, affordability management, financial controls, payment integrity, financial modeling, or managing large-scale medical and behavioral healthcare expenditure targets.
Leadership experience: At least two years of supervisory experience managing a minimum of two employees, with the ability to lead teams, develop talent, and drive performance.
Preferred education: Master's degree in Business Administration, Healthcare Administration, Finance, Economics, Public Health, or a related discipline.
Preferred professional background: Ten or more years of progressively responsible experience in Medicaid managed care, Tailored Plans, LME-MCO organizations, healthcare economics, medical economics, affordability management, healthcare finance, population health, utilization management, network management, or government healthcare programs.
Strategic leadership: Proven ability to lead enterprise-wide cost management initiatives and implement strategies that influence healthcare expenditure trends and improve affordability.
Analytical and financial skills: Strong understanding of healthcare financial performance, cost drivers, utilization trends, financial forecasting, and the development of measurable savings initiatives.
Communication and stakeholder management: Excellent interpersonal, presentation, and communication skills, including the ability to translate complex financial and healthcare data into clear recommendations for executive leadership.
Collaboration and problem-solving: Ability to work effectively across multidisciplinary teams, influence senior stakeholders, and drive organizational change in a complex healthcare environment.
Additional requirements: Must hold a valid driver's license, reside within the United States, and be legally authorized to work in the United States without current or future employment sponsorship.
Benefits:
Annual salary: $144,763–$180,479, depending on qualifications and experience.
Remote work opportunities for most positions, including this United States-based leadership role.
Flexible working arrangements available with management approval.
Typical working hours of 8:30 a.m. to 5:00 p.m.
Comprehensive health insurance with no employee premium for individual coverage.
Flexible Spending Accounts (FSA).
Generous paid time off, including 24 days of PTO and 12 paid holidays during the first year.
Participation in the North Carolina Local Government Retirement System (LGERS), offering a defined-benefit pension plan.
401(k) retirement savings plan with a 5% employer match and immediate vesting.
Eligibility as an employer for the Public Service Loan Forgiveness (PSLF) program.
Quarterly stipend to support remote work supplies.
Collaborative, mission-driven working environment.
Opportunities for professional development and career growth within an inclusive and diverse organization.