Position Spotlight: Director of Medical Economics
Lydia is from Tampa, Florida, moved to Nashville, Tennessee in 2008, but recently relocated to Austin, Texas. Her background is in Accounting and Risk Management, and she spent several years Underwriting at Cigna. She joined Contessa as the Manager of Medical Economics in 2018. In her free time, she enjoys thrifting, visiting art museums, drinking coffee with friends, and doing art projects with her husband and son.
What does the Director of Medical Economics do at Contessa?
I view our Medical Economics department as a combination of Underwriting and Risk Management. My team and I primarily create pricing proposals from start to finish. That includes evaluating claims data, thinking through any operational nuances that could have a financial impact, structuring our rate schedules, creating financial models and projections, proposing rates, providing support during negotiations, reviewing the contracts, and making sure any downstream administrative items are in place to help our program run smoothly. Plus, we do plenty of ad hoc analyses wherever those are needed, whether that is for our Contessa team or our clients. We stay busy!
Why did you choose a career in Medical Economics?
While all of my career has been in the finance family, I have had a variety of roles from Internal Audit to Medical Underwriting – I was even an Insurance Regulator for a time! Medical Economics is a great fit for me because takes the bits and pieces I loved from all of those experiences and then mixes in some new skills. It is fast-paced, detail-oriented work, but still requires a broader risk management mindset.
How does the work you do at Contessa differ from other health plan positions?
I have found that Contessa is very interconnected, while other health plans tend to be very segmented. I regularly work with people across every department at Contessa. If I have a question on a medical procedure code, I have a nurse, a claims specialist, a biostatistician, a lawyer, and a software engineer on speed dial! That is really something special! Being so connected to the collective knowledge of our team makes me feel like there is no question we can’t answer!
What is the best part of your job?
I love that the work my team and I do is very high impact. My team develops the pricing for every patient episode. Each contract we finalize allows us to admit a new group of patients to the program. It’s very satisfying to have a direct and measurable impact on the program.
What’s the most challenging part of your job?
Healthcare is very complex, localized, and changes all the time. Plus, Contessa is doing something new within an already complicated industry. We work hard to think through every risk that could impact our program as we work through pricing, but there is no guidebook. Every proposal presents a different challenge.
What inspires you to come to work every day?
Our team here at Contessa! It is so motivating to work with so many smart, driven, passionate people. I learn something new every single day.