The Director of Healthcare Economics & Analytics is a senior leader responsible for shaping how the organization measures, interprets, and improves the financial and clinical performance of its value-based care programs. This role combines actuarial modeling, healthcare economics, and applied health services research to ensure programs deliver measurable improvements in cost, quality, and health outcomes—particularly for Medicaid and Medicare populations.
This role partners cross-functionally with Clinical, Operations, Technology, Partner Success, and executive leadership. The Director will oversee forecasting, risk modeling, claims analysis, program evaluation, and enterprise reporting while building scalable analytical frameworks that support both internal decision-making and external stakeholder engagement.
This leader will serve as both a strategic thought partner and hands-on technical expert, advancing analytic rigor, innovation, and impact measurement across the organization.
Job Specifics
In this position you will:
- Shape enterprise-wide frameworks to measure population health impact, cost performance, and value-based contract outcomes.
- Partner with finance and operations to inform strategic planning, contract negotiations, and care model evolution.
- Develop and maintain medical economics models to assess risk, forecast financial outcomes, and support performance of risk-bearing and value-based contracts.
- Develop scalable dashboards and reporting assets that support leadership decision-making.
- Analyze medical and pharmacy claims data to identify cost drivers, performance gaps, and opportunities for program improvement.
- Support medical cost trend analysis, premium performance forecasting, and downside risk modeling.
- Provide actionable insights to strengthen impact across medical, pharmacy, and other cost domains.
- Ensure medical economics practices align with regulatory standards and industry best practices.
You will be a good fit if you have:
- Bachelor’s degree in Actuarial Science, Mathematics, Statistics, Economics, Public Health, Health Services Research, or related quantitative field required.
- ASA (Associate of the Society of Actuaries) preferred for actuarial-focused candidates; FSA a plus.
- Advanced degree (MS, MPH, PhD, or equivalent) in a quantitative or research discipline preferred but not required.
- 8–10+ years of experience in healthcare economics, actuarial analysis, health services research, or related field.
- Significant experience working with Medicaid & Medicare populations.
- Demonstrated expertise in claims analysis, cost modeling, and evaluating value-based care arrangements.
- Advanced modeling and statistical analysis capabilities.
- Proven track record of evaluating care program effectiveness and translating findings into operational improvements.
- Experience supporting financial processes including medical expense forecasting, accruals, and risk assessment.
- Experience working in managed care, provider risk-bearing entities, healthcare services organizations, or applied research environments.
- Ability to synthesize complex quantitative findings into clear executive-level insights.
Traits that will lend to your success at firsthand:
- Mission-driven with a strong commitment to advancing health equity and serving underserved communities.
- Empathetic, humble, and highly conscientious.
- Deeply curious with a continuous learning mindset.
- Strong attention to detail and commitment to high-integrity work products.
- Comfortable with ambiguity and capable of driving clarity in evolving environments.
- A collaborative leader who represents organizational mission, vision, and values authentically.
We firmly believe that great candidates for this role may not meet 100% of the criteria listed in this posting. We encourage you to apply anyway - we look forward to begin getting to know you.
Benefits
For full-time employees, our compensation package includes base, equity (or a special incentive program for clinical roles) and performance bonus potential. Our benefits include physical and mental health, dental, vision, 401(k) with a match, 16 weeks parental leave for either parent, 15 days/year vacation in your first year (this increases to 20 days/year in your second year and beyond), and a supportive and inclusive culture.
Top Skills
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