Director, Medical Economics

This is a fully remote position, open to applicants in United States.

📋 Description

• Collaborate with the VP of VBC Impact & Strategy to convert analytic plans, data needs, metrics, and evidence required for evaluating the impact of value-based care models.

• Design and implement analyses covering clinical, financial, operational, quality, utilization, patient experience, and health-equity performance metrics.

• Utilize attribution, risk adjustment, benchmarking, trend analysis, cohort comparison, and program evaluation methodologies.

• Record assumptions, limitations, methodological considerations, and levels of confidence in findings.

• Identify and assess factors influencing cost, utilization, quality, clinical outcomes, and various performance indicators.

• Create analytic reports, visual aids, summaries, source logic, and supplementary materials for payers, providers, state officials, executives, Board members, and growth-oriented audiences.

• Adapt analyses to specific populations, markets, payer partners, provider networks, and programs while ensuring methodological consistency.

• Work in partnership with Medical Economics, Actuarial, Clinical, Operations, Finance, Product, Network, Growth, and data teams.

• Sustain a prioritized analytic work plan and a consistent delivery schedule for VBC Impact & Strategy initiatives.

• Assist in analytic governance, documentation, and the establishment of reusable measurement standards.

• Address ad hoc analytic inquiries and deliver timely, decision-ready outputs.

• Manage issues related to resources, methodologies, data, and prioritization.

⛳️ Requirements

• Over 7 years of progressive experience in medical economics, healthcare analytics, actuarial analysis, outcomes research, population health, value-based care, or a related area.

• Strong knowledge of value-based care programs and healthcare claims, along with clinical, financial, quality, and operational data.

• Proficiency in relational databases and statistical programming.

• Experience in evaluating healthcare interventions through comparative, longitudinal, or other robust program-evaluation techniques.

• Expertise in causal inference and quasi-experimental study design.

• Familiarity with attribution, risk adjustment, benchmarking, trend analysis, program evaluation, and financial impact assessment.

• Capacity to conduct thorough analyses, elucidate methods and limitations, and convey findings to both technical and non-technical stakeholders.

• Experience collaborating across functions with clinical, actuarial, finance, analytics, operations, product, network, growth, or commercial teams.

• Bachelor’s degree in economics, statistics, mathematics, public health, health services research, actuarial science, business, data science, or a related field.

• Preferred: Experience with Medicaid managed care and populations, including associated clinical, social, operational, and economic aspects.

🏝️ Benefits

• Equal employment opportunity and anti-discrimination policy.

• Benefits information available through a prospective candidate flyer (specific benefits not disclosed in the posting).