Bright Health
Through powerful relationships with care partners, Bright Health aims to help people live healthier and brighter lives
Austin, TX

Director, Medical Cost Management at Bright Health

| Austin
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Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.

What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.

If you share our passion for changing healthcare so all people can live healthy, brighter lives – apply to join our team.


The Director, Medical Cost Management is a critical part of the Bright Health Plan Texas Market leadership team and is responsible for development and implementation of strategies to manage and mitigate medical costs trend, thus enabling the provision of affordable products to members. This role requires the appropriate background and experience to partner with clinical, network, pharmacy and local market leadership to identify and implement cost savings action plans. This role is responsible for medical cost management activities across multiple lines of business: Individual and Family Plan, Medicare Advantage and Employer. Responsibilities include leading all market based medical cost activities and potentially a market based unit. Position is accountable for defining priorities and implementing timely solutions, in collaboration with cross-functional senior leaders.

The successful candidate will be a self-starter with a proven track record of succeeding in fast-paced and complex health care settings. It requires using data to make informed recommendations to business process impacting both external and internal stakeholders and be able to proactively optimize solutions. The candidate will lead with accountability; have excellent verbal and written communication skills and operate with strong attention to detail. Colleagues and clients would recognize the candidate for leading through influence, having empathy towards others, being highly collaborative and strongly exhibit ability to drive towards measurable outcomes.
ROLE RESPONSIBILITIES
The Director, Medical Cost Management job description is intended to point out major responsibilities within the role, but it is not limited to these items.

  • Assess and develop immediate Medical Cost management initiatives for Texas
  • In collaboration with the Finance Cost Management team, identify cost trends for quantification and prioritization for the Texas Market
  • Partner with business leaders (clinical, network, pharmacy, etc.) to develop solutions to manage identified medical cost risks and opportunities for the Texas Market. Ensure measurement of outcomes of implemented solutions.
  • Other duties as assigned.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
• Bachelor’s degree (Required), Master’s Degree Preferred
• 10 (ten) or more years of progressive experience in managed healthcare, with emphasis on developing and implementing programs to manage costs (Required)
• 7 (seven) or more years of experience in managing to affordability targets (Required)
• Strong clinical and network contracting background
• Advanced proficiency with Microsoft Excel and Microsoft Power Point (Required
• Familiarity with Tableau and other reporting tools.


PROFESSIONAL COMPETENCIES
• Broad health care background with knowledge and experience in both medical and pharmacy benefits
• In depth knowledge of potential cost drivers; clinical, network, utilization trends including high cost specialty medications.
• Proven ability to manage to affordability targets
• Skilled at working with vendors to support cost containment
• Proven ability to collaborate with BH risk-based partners in identifying and solutioning for cost drivers
• Strong collaboration skills to effectively design cost mitigation solutions that meet the business needs
• Ability to initiate and oversee success of cost mitigation/cost drivers
• Ability to perform critical analysis of complex business problems and propose appropriate solutions
• Experience and strong influential skills to manage cross-functional, virtual teams
• Excellent written and verbal communication skills
• Ability to understand and identify regulatory and implementation risks and develop mitigation strategies
• Ability to perform multiple tasks and prioritize simultaneously
• Ability to effectively engage and interact with and influence internal executive sponsors
• Advanced time management, project management, and analytical skills
• High attention to detail
• Strong analytical skills, work ethic, problem solving ability, and overall positive attitude
• Demonstrated flexibility, organization, and self-motivation
• Adaptable to change

LICENSURES AND CERTIFICATIONS
• No licensures and/or certifications are required for this role.

 
We’re Making Healthcare Right. Together.
We are realizing a completely different healthcare experience where payors, providers, doctors, and patients can all feel connected, aligned and unified on the same team. By eradicating the frictions of competing needs, we are making it possible to give everyone more of what they want and deserve. We do this by:
 
Focusing on Consumers
We understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.
 
Building on Alignment
We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.
 
Powered by Technology
We employ our purpose built, integrated data platform to connect clinical, financial, and social data, to deliver exceptional outcomes.
 
          
 
As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
 

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Where we are

We are downtown at 515 Congress Avenue, right in the heart of downtown! Tons of restaurants and close to public transportation.

Technology we use

  • Engineering
  • Product
  • Sales & Marketing
    • .NETLanguages
    • C#Languages
    • JavaLanguages
    • JavascriptLanguages
    • PythonLanguages
    • ScalaLanguages
    • SqlLanguages
    • PowerShellLanguages
    • D3JSLibraries
    • ReactLibraries
    • ReduxLibraries
    • FlutterLibraries
    • ExpressFrameworks
    • Node.jsFrameworks
    • MongoDBDatabases
    • MySQLDatabases
    • PostgreSQLDatabases
    • InVisionDesign
    • SketchDesign
    • Lucid ChartDesign
    • Aha!Management
    • ConfluenceManagement
    • JIRAManagement
    • Microsoft ProjectManagement
    • Microsoft DynamicsCRM

What are Bright Health Perks + Benefits

Bright Health Benefits Overview

We have 3 different health insurance plans, all through Cigna (HDP, Premium HDP and PPO). We cover the majority of the cost for the employee and some cost for family. We have two dental plans and a vision plan as well. We have a Lifestyle Spending Account and options for HSA/FSA. We put 3% of your total earnings into your 401K plan and you are immediately vested. We have all the latest technology (Mac or Surface laptops – your choice) to use including standing desks. Fully stocked fridge with snacks and drinks.

Culture
Friends outside of work
Eat lunch together
Daily sync
Open door policy
Team owned deliverables
Team based strategic planning
Group brainstorming sessions
Pair programming
Open office floor plan
Diversity
Dedicated Diversity/Inclusion Staff
Unconscious bias training
Someone's primary function is managing the company’s diversity and inclusion initiatives
Mean gender pay gap below 10%
Hiring Practices that Promote Diversity
Health Insurance & Wellness Benefits
Flexible Spending Account (FSA)
Bright Health employees can contribute up to $3500 annually to their FSA.
Disability Insurance
Dental Benefits
Vision Benefits
Health Insurance Benefits
Life Insurance
Wellness Programs
Bright Health is proud to offer a wellness stipend of $200/month to all employees!
Onsite Gym
Mental Health Benefits
Retirement & Stock Options Benefits
401(K)
We will put 3% of your total earnings into your 401K plan, even if you don't put anything in. It's a safe harbor contribution.
401(K) Matching
Bright Health provides employees with a 401(k) plan managed by Vanguard. We provide a ‘safe harbor’ non-elective contribution equal to 3% of your compensation, regardless of participation in the p
Performance Bonus
Child Care & Parental Leave Benefits
Generous Parental Leave
We provide up to 6 weeks of parental leave for the primary caretaker. We also provide 2 weeks of leave for the secondary caretaker.
Flexible Work Schedule
Bright Health provides employees with a flexible work schedule that includes Core hours, Flexible start and end times.
Remote Work Program
Family Medical Leave
Company sponsored family events
Bright Health sponsors family oriented events Annually.
Vacation & Time Off Benefits
Generous PTO
Paid Holidays
Paid Sick Days
Perks & Discounts
Casual Dress
Commuter Benefits
Stocked Kitchen
Happy Hours
Happy hours are hosted on occasion.
Relocation Assistance
Fitness Subsidies
Bright Health employees are eligible for discounts on several gym memberships.
Home Office Stipend for Remote Employees
Professional Development Benefits
Diversity Program
Lunch and learns
Cross functional training encouraged
Promote from within
Online course subscriptions available
Customized development tracks

Additional Perks + Benefits

Bright's primary goal is to offer employee benefits and perks that are as flexible as possible to meet each employee's unique needs!

An Insider's view of Bright Health

What’s the vibe like in the office?

The office has a relaxed and laid back vibe but people are very serious about their work - perfect!

Anthony

Data Engineer

What does your typical day look like?

My day is so varied, given how quickly we're growing, which is fulfilling for me. I have a good balance of strategic and tactical work in my day as well as time to focus and time to collaborate.

Jen

VP, Digital

What makes someone successful on your team?

A hard-working team player who thinks first and codes next is likely to learn a lot and quickly become a valuable member of the team. Lots of experience with some of our tooling is always nice, but if someone can't knowledge-share well or responds poorly to code reviews and other requests for collaboration, it'll be a tough fit.

Brian

Software Engineer 3

How do your team's ideas influence the company's direction?

We hire smart individuals who thrive on accomplishment and purpose. Our teams are exposed to the bigger picture through constant communication and dialogues – that encourages them to come up with innovative solutions to problems. We've made significant adjustments on our direction in technology and process that were initiated by the team.

Abdullah

VP, Engineering

Bright Health Careers In Austin
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Manager, IFP Sales Strategy

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Remote
2 weeks ago
ROLE RESPONSIBILITIES The Manager, Clinical Program Operations job description is intended to point out major responsibilities within the role, but it is not limited to these items. Responsible for the overall management and relationship with external vendors that provide services and activities either delegated and/or support the Clinical Operations department. Coordinate, facilitate, and manage all vendor management tasks inclusive of working with external vendors and internal employees. performance of vendors and their operational systems including configuration and customization necessary to support business functions. Troubleshoot all vendor problems and present to management as required.

Manager, Infrastructure Operations

Bright Health
Remote
3 weeks ago
Back to Career Site Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes. What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be

Director, Analytics and Reporting - Risk Adjustment

Bright Health
Remote
3 weeks ago
Back to Career Site Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes. What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be

Complex Care Nurse/Nurse Supervisor

Bright Health
Remote
3 weeks ago
Back to Career Site Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes. What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be

Senior Analytics Consultant

Bright Health
Remote
3 weeks ago
Back to Career Site Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes. What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be

Director, Security Engineering

Bright Health
Austin
3 weeks ago
Back to Career Site Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes. What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be

Lead Business Systems Analyst

Bright Health
Remote
17 hours ago
Back to Career Site Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes. What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be

Software Engineer - Dynamics CRM

Bright Health
Austin
2 days ago
Back to Career Site Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes. What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be

Director, Provider Contracting

Bright Health
Remote
2 days ago
Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.

Medical Cost Financial Consultant

Bright Health
Remote
2 days ago
Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.

Project Manager (Actuarial - Government Programs & Provider Risk)

Bright Health
Remote
2 days ago
Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.

Senior Actuarial Analyst

Bright Health
Remote
2 days ago
Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.

Senior Actuarial Analyst

Bright Health
Remote
2 days ago
Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.

Sr. Actuarial Director, Individual ACA

Bright Health
Remote
2 days ago
Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.

Actuarial Analyst - Provider Risk

Bright Health
Remote
2 days ago
Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.

Actuarial Consultant– Reserving

Bright Health
Remote
2 days ago
Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.