Director, Medical Economics

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

📋 Description

• Lead the analytics for medical expenses, medical loss ratio (MLR), utilization, quality, and pharmacy performance within value-based care contracts.

• Assist in the creation of client-facing materials, reporting, executive reviews, and analytics for board-level presentations.

• Supervise the development and ongoing refinement of Medical Economics reporting tools, dashboards, and performance management systems.

• Ensure that reporting is precise, actionable, and aligns with the goals of the organization.

• Promote governance and ongoing enhancement of analytical methodologies and business definitions.

• Measure the expected and actual financial impacts of enterprise initiatives.

• Collaborate with IT and Finance to guarantee appropriate data structure and reporting.

• Act as a trusted advisor to senior leadership, clinical leaders, operations, client partnerships, and finance teams.

• Convert technical findings into clear, executive-level recommendations.

• Develop scalable and adaptable solutions to data-related challenges.

• Lead strategic and ad hoc analytical projects, prioritizing tasks in a dynamic organizational environment.

⛳️ Requirements

• Bachelor’s degree in finance, mathematics, statistics, Actuarial Science, economics, or a related discipline.

• Preferred actuarial designation (ASA or FSA).

• At least 5 years of prior experience in a value-based provider group and/or health plan.

• Minimum of 2 years of experience in coaching, leading, and hiring a high-performing team.

• Experience in coaching individual performance, recruitment, and managing resources and bandwidth.

• Highly proficient in Microsoft Excel, SQL, and a variety of reporting tools.

• Familiarity with Databricks, Power BI, or large-scale healthcare data platforms.

• Comprehensive understanding of healthcare claims, utilization management, risk adjustment, value-based care, and population health performance metrics.

• Advanced analytical and problem-solving abilities.

• Capacity to synthesize large datasets into actionable business recommendations.

• Experience in communicating findings to executive-level audiences.

• Ability to manage multiple priorities in a fast-paced environment.

• Strongly preferred experience in Medicare Advantage.

• Experience supporting value-based arrangements, shared savings models, or risk-based contracts is preferred.

🏝️ Benefits

• Medical, dental, and vision insurance.

• Employee assistance program.

• Employer-paid and voluntary life insurance.

• Disability insurance.

• Health and flexible spending accounts.

• Competitive compensation.

• 401k with employer match.

• Financial wellness resources.

• 20 PTO days.

• 7 paid holidays.

• 1 floating day.

• Paid parental leave.

• Work-life assistance resources.

• Physical wellness perks.

• Mental health support.

• Employee referral program.

• BenefitHub employee discounts.