Principal, Medical Economics

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

📋 Description

• Lead and establish statistical analyses to pinpoint cost, utilization, and performance drivers across various populations, markets, and payer arrangements.

• Collaborate with data, actuarial, and analytics teams to validate healthcare claims data structures, ensuring accurate representation in enterprise datasets and resolving discrepancies that impact downstream reporting and analysis.

• Utilize economic insights to enhance impact modeling and quantify the financial and operational implications of clinical and business initiatives.

• Create experimental designs for new program initiatives to guarantee that programs are prepared for impact analysis from the outset.

• Convert complex claims, reimbursement, and utilization data into clear, actionable recommendations for cross-functional stakeholders and senior leadership.

• Detect trends, anomalies, and emerging opportunities within claims and performance data, and communicate their implications for value-based care strategy.

⛳️ Requirements

• Bachelor’s degree in economics, statistics, mathematics, public health, healthcare administration, data science, or a related field; an advanced degree is preferred.

• Over 8 years of experience in healthcare analytics, medical economics, actuarial analytics, or a related analytical role within the healthcare sector, focusing on medical cost, utilization, or financial performance metrics. Experience with causal inference is preferred.

• Comprehensive understanding of healthcare claims data structures, medical coding systems, and reimbursement concepts, including ICD-10-CM, CPT, HCPCS, DRGs, capitation, fee-for-service, and value-based payment models.

• Proven ability to evaluate data quality, investigate discrepancies, and collaborate with technical teams to enhance data integrity and usability.

• Proficient SQL skills are required; familiarity with Python, R, or other analytical tools is preferred.

• Exceptional problem-solving, critical thinking, project management, and cross-functional collaboration skills, with the capability to influence stakeholders at various levels of the organization.

• Capable of working efficiently in a primarily remote environment: Home internet must support a minimum download speed of 25 Mbps and an upload speed of 10 Mbps. Cable, Fiber, or DSL connections hardwired to the internet device are recommended. Evergreen will supply remote employees with telephony applications and equipment to fulfill the business requirements for their role. Employees must operate from a dedicated space free from ongoing interruptions to protect member PHI / HIPAA information.

🏝️ Benefits

• Paid time off beginning at 4 weeks for full-time employees.

• 12 paid holidays each year.

• Medical, dental, vision, and life insurance, including an HSA with employer match.

• Reimbursement for continuing medical education for eligible positions.

• A 401(k) program where Evergreen matches up to 4% of contributions after six months of employment.

• Paid parental leave.

• A comprehensive training and development program that commences with onboarding and continues throughout your career with Evergreen Nephrology.