Senior Medical Economics Analyst
Overview
We are partnering with a leading value-based care (VBC) provider focused on improving outcomes and reducing cost of care across Medicare Advantage populations. This organization is rapidly scaling and seeking a Senior Medical Economics Analyst to drive data-driven insights across financial, clinical, and operational performance.
This individual will play a critical role in analyzing cost, utilization, and risk trends while supporting performance across full-risk and shared-risk arrangements.
Key Responsibilities
- Analyze medical cost, utilization, and revenue trends across Medicare Advantage populations to identify drivers of performance
- Build and maintain standardized reporting and dashboards supporting VBC performance across clinical, finance, and operations teams
- Work with payer claims, capitation, and membership data to produce actionable insights and track patient panels
- Develop processes to identify new and attributed members, high-risk populations, and cost-saving opportunities
- Partner cross-functionally with clinical, population health, finance, and contracting teams to support decision-making
- Translate value-based contracts into analytical frameworks, tracking performance against key metrics such as total cost of care, MLR, RAF, and quality measures
- Identify and evaluate cost containment and utilization management opportunities, including outlier analysis and intervention impact
- Support monthly and quarterly reporting cycles, including variance analysis, forecasting, and executive-level summaries
- Communicate insights clearly to stakeholders, providing data-driven recommendations to improve financial and clinical outcomes
Qualifications
- 4-8+ years of experience in medical economics, healthcare analytics, or actuarial analytics
- Strong experience supporting Medicare Advantage populations (required)
- Experience in value-based care models (ACO, capitation, shared savings, or full-risk arrangements)
- Advanced SQL skills and experience working with large healthcare datasets
- Experience building datasets, reporting tables, and dashboards (not just performing analysis)
- Proficiency with tools such as Power BI, Tableau, or Looker preferred
- Strong understanding of:
- Medical cost and utilization drivers
- Claims, enrollment, and risk adjustment data
- Value-based contract structures and performance metrics
Nice-to-Have
- Experience with risk adjustment (RAF), STARS, or quality performance analytics
- Exposure to automation or advanced analytics tools (Python, R)
- Experience building scalable reporting frameworks or analytics products
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