About Employer Direct Healthcare
Employer Direct healthcare (EDH) is on a mission to transform access to excellent care for the moments that matter most. As the leading provider of surgical benefits for self-insured employers, we bring guided access to high-quality, affordable care for employers, their employees and the family members. We understand and have experienced the challenges of navigating specialized healthcare and we are dedicated to making a change.
EDH is the market leader for Independent Centers of Excellence (CoE). We have challenged the status quo in healthcare by bringing top quality surgeons within reach of all. Our surgeon-first model is the largest and most accessible network (3-4x larger than our peers), which has delivered an ROI 3x our peers. We serve hundreds of self-funded plan sponsors across 1000+ employers, representing over 4 million people across the U.S. We've saved our clients over $700 million since we were founded!
Ultimately, the US healthcare system at-large is flawed. Costs continue to rise while life expectancy stagnates. We are moving the needed on this problem by improving surgery outcomes - making people healthier - and lowering healthcare costs at the same time.
About You:
- You have a drive and AMBITION to tackle big problems. Big problems require big ideas and a team that supports new ideas.
- You CARE deeply for your customers. Your customers aren’t just the individuals using your product. They are the driving factor in your motivation to make a change.
- You thrive in a TEAM ENVIRONMENT. Collaboration is key in innovation and creating change.
- A DIVERSE environment is incredibly important to you. You understand and desire to be a part of a diverse team with different experiences and perspectives & you cherish the differences in each individual that you interact with.
- You are DETAIL ORIENTED, but more so, focus on the execution of your content while balancing a fast-paced environment.
- You understand that PROGRESS is critical to making change. You take the time to celebrate the small and big wins. Understanding that each improvement to a process helps move towards a greater change.
- INTEGRITY guides you in life. Focusing on the truth versus just giving people the answers they want to hear.
If this sounds like you, we would love to connect to speak further about career opportunities at Employer Direct Healthcare.
Please apply to our role & someone from our HR Team will reach out to help you navigate our interview process.
Director of Claims and Savings Analysis
The Director of Claims and Savings leads the team that delivers the analyses that allow our business to grow and function – for our existing clients, this is the identification of savings delivered and for our prospective clients, this is the identification of the savings opportunity. In addition to running the team that delivers these analyses, the Director of Claims and Savings will push our thinking by developing new, best-in-class methodologies, and helping translate those analyses and findings for our clients and their representatives (e.g., consultants, brokers) to help build and strengthen our reputation in the market. This position reports to the VP of Strategy
Location: Remote | USA | Travel Required
Responsibilities:
- Own the creation and delivery of our savings calculation methodologies
- Establish a roadmap for improvements in our savings analysis process and action plan to move to a more proactive and replicable approach
- Drive our market-facing savings validation activities
- Own all client and prospective client claims repricing
- Act as an SME in cross-functional discussions with commercial, client success, accounting, analytics, etc.
Requirements:
- Bachelor’s degree required: advanced degree in statistical analysis, health policy or related field preferred
- 10+ years’ experience working in healthcare professional services such as actuary, claims analysis, consulting or similar environment
- Experience managing a team of direct-reports preferred
- Strong qualitative and quantitative analysis with experience in excel required; preference for advanced statistical tools (e.g., python, snowflake, etc.)
Soft Skills & Characteristics:
- Intellectual horsepower
- Driven, ambition, urgency, comfort with a fast pace
- Autonomous, self-starter
- Intellectual curiosity
- Deep healthcare background/knowledge
Benefits
- Medical Insurance
- Dental Insurance
- Vision Insurance
- Short & Long Term Disability
- Life Insurance
- 401k with company match
- Paid Time Off
- Paid Parental Leave
Employer Direct Healthcare does not discriminate on the basis of race, sex, color, religion, age, national origin, marital status, disability, veteran status, genetic information, sexual orientation, gender identity or any other reason prohibited by law in provision of employment opportunities and benefits.