Sr. Director, Healthcare Economics

What You’ll Do  

We are seeking a strategic and operationally minded Senior Director of Medical Economics to direct and manage the Total Cost of Care (TCOC) function at our VBC-focused care management company. This is a key role within the Finance team leveraging data to enable total cost of care management, clinical and operational performance optimization and understanding impactable cost and utilization drivers. The SD will oversee the Medical Economics team, with responsibility for delivering insights that directly inform program effectiveness and financial outcomes. This position will report directly to the VP, Informatics. 

The Day to Day  

• Direct a team of Med econ analysts to deliver regular, meaningful cost of care analyses and reporting. 
• Drive data-driven decision-making and cost containment. 
• Partner with internal stakeholders (clinical, operations, actuarial, finance, product) and external stakeholders (payers, providers) to translate complex data into actionable insights. 
• Prioritize, plan and manage requests ranging from ad-hoc studies to support with new cost containment initiatives and regular cost of care reporting. 

 

Total Cost of Care & Medical Economics 

• Own all analytics related to Total Cost of Care, utilization patterns, network efficiency, and care outcomes. 
• Direct the Medical Economics team in developing actionable models and reports on  cost drivers, nephrology practice performance, clinical outcomes tracking from leading, interim and lagging indicators. 
• Development of targets for leading performance indicators; work directly with actuarial team in clinical forecast development.  

Team & Organizational Leadership 

• Manage and mentor high-performing analytics talent, with a focus on execution, innovation, and business alignment. 
• Build and scale infrastructure, tools, and data pipelines in partnership with engineering and product. 
• Cultivate a culture of data literacy across the organization. 

 Minimum Qualifications  

• Bachelor’s degree in a quantitative or healthcare-related field required, such as applied statistics, econometrics, health informatics or data science. 
• 7+ years of progressive experience in healthcare analytics, informatics, medical economics, or related roles. 
• 3+ years of experience in value-based care, health plans, provider enablement, or population health settings. 
• 5+ years of experience in TCOC analysis, program reporting HCC risk adjustment, quality measures (e.g., HEDIS, Stars), and provider performance analytics. 
• Internet Connectivity - Min Speeds: 3.8Mbps/3.0Mbps (up/down): Latency <60 ms.
• Ability to travel and be on-site to meet business needs.

Preferred Qualifications  

• Associate of the Society of Actuaries or Masters in Math, Statistic, analytical, engineering or STEM discipline, preferred. 
• 6+ years of demonstrated leadership of analytics teams, including 5+ years managing direct reports at the director level (or greater).
• Proficiency with modern data tools and platforms (e.g., SQL, Python, Snowflake, Tableau,). 
• Experience working with payers or provider organizations operating under value-based contracts. 
• Direct oversight of both Medical Economics function. 
• Familiarity with CMS programs (ACO REACH, MSSP, MA). 

 

About You  

• Proven ability to communicate complex analytical concepts to non-technical stakeholders and senior leadership. 
• Proven ability to direct, manage and develop high-performing teams, with a strong focus on fostering collaboration and driving results. 
• Strong problem-solving skills with the ability to thrive in a fast-paced, dynamic environment.  

  

Annual Base Salary Range: $153,000 - $191,000