Medical Economics Director

Roanoke, VA, US, 24011

Job Summary

The Medical Economics Director assumes the leadership role in Organization Management of medical economics, to include, but not limited to rate proposal development and negotiation analyses across the Healthcare System. Develops the Medical Economic strategy and reimbursement proposals for managed care contracts. Directs and manages reimbursement modeling, hospital contract modeling, performance monitoring and fee schedule auditing. Supports multiple highly variable priorities with aggressive timelines to ensure maximum revenue to Carilion entities.  In addition, ensures that reimbursement proposal terms fall within the approved pricing strategy.  Provides leadership for the effective and efficient operation of these services and ensures that the activities and goals of these services are aligned with the business plan for the Carilion Clinic.

Step up and lead with a regional leader. Advance your career with an award-winning organization that excels in helping our communities stay healthy and our region grow stronger. Make the most of your management talents at Carilion Clinic, an award-winning healthcare network that includes seven hospitals, multi-specialty physician practices, and affiliations with prestigious academic medical institutions.

Based in Roanoke Virginia, we offer compassionate care, medical education and research, and neighborhood outreach programs. Join and guide a team of caring individuals who embrace and reflect our values‐commUNITY, courage, commitment, compassion, and curiosity‐in all that we do. And realize the advantages of professional stability, strong technological resources, and true advancement potential.

Minimum Qualifications

Education:  Master’s degree in business administration or related field required.  Bachelors degree with 10 or more years of experience may be considered.

Experience:  8-10 years of experience in medical economics, payor relationships, managed care contractual terms and requirements.

Other Minimum Qualifications: Effective management skills including time management, communications, human relations, presentation and organization skills.  Demonstrate clear and concise communication skills, both oral and written.  Ability to conduct in-depth product presentation ins a variety of settings.  Computer literate in office based applications. Knowledge of software to quantify and illustrate issues such as Crystal Reporting and, Epic Contract Module.  Working knowledge of health insurance practices, industry regulator requirements, business office operations, patient registration, charge master, revenue audit, billing and accounts receivable functions, claim auditing, financial reporting technology and industry standards for healthcare revenue resolution

Our Values

Below are our core values that we strive to embody and expect of all our team members:

Collaboration: Working together with purpose to achieve shared goals.
Commitment:  Unwavering in our quest for exceptional quality and service.
Compassion:  Putting heart into everything we do.
Courage:  Doing what’s right for our patients without question.
Curiosity:  Fostering creativity and innovation in our pursuit of excellence.


Requisition Number: 74397 
Employment Status: Full time 
Location: CASB - Carilion Administrative Services Building 
Shift: Day 
Shift Details: M-F, 8-5
Recruiter: DAVID L NIVEN 
Recruiter Phone: 540-983-4057 
Recruiter Email: dlniven@carilionclinic.org
For more information, contact the HR Service Center at 1-800-599-2537.

This is Carilion Clinic ...

An organization where innovation happens, collaboration is expected and ideas are valued. A not-for-profit, mission-driven health system built on progress and partnerships. A courageous team that is always learning, never discouraged and forever curious.

Headquartered in Roanoke, Va., you will find a robust system of award winning
hospitals, Level 1 and 3 trauma centers, Level 3 NICU, Institute of Orthopedics and Neurosciences, multi-specialty physician practices, and The Virginia Tech Carilion School of Medicine and Research Institute.

Carilion is where you can make your own path, make new discoveries and, most importantly, make a difference. Here, in a place where the air is clean, people are kind and life is good. Make your tomorrow with us.

Equal Opportunity Employer

Minorities/Females/Protected Veterans/Individuals with Disabilities/Sexual Orientation/Gender Identity

Carilion Clinic is a drug-free workplace.


Nearest Major Market: Roanoke

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