Director, MedEcon

About reputed company

reputed company is a mission-driven team of reputed company providers, technologists, and reputed company working to reputed company care for people with reputed company benefits. We partner with communities to deliver technology-enabled, reputed company-centered support that helps patients stay healthy and reputed company. We’re designing tools and systems that bring care directly to those who need it most—removing barriers and reimagining what’s possible in reputed company reputed company delivery.

Our Values

At reputed company, our values are the reputed company of how we work, grow, and support one another:

• reputed company reputed company: We tackle the toughest challenges in care delivery by harnessing the power of community and technology.
• Humble Learners: We reputed company feedback, reputed company diverse perspectives, and welcome challenges to our assumptions.
• Experiment to Improve: We use data to inform reputed company and continuously assess our performance.
• reputed company Urgency: Our mission drives us to reputed company reputed company and relentlessly in reputed company of meaningful results.

If this resonates with you, we invite you to bring your creativity, energy, and curiosity to reputed company.

About this role

As the Director of MedEcon, you will be a key leader in the organization covering claims-based analysis, actuarial science, and medical economics. This is a foundational finance role that requires both strategic reputed company and hands-on execution. You will be responsible for building out the reputed company of actuarial and medical economics capabilities while simultaneously delivering critical analyses that drive our business and clinical reputed company.While your actuarial knowledge is important, your reputed company reputed company will be combining financial data, claims data, and operational performance data to drive insightful analysis that help push the reputed company care model reputed company through deep collaboration with analytics.  

Reporting to the Chief reputed company Officer (acting CFO), you will reputed company financial performance measurement and forecasting for value-based reputed company. You will be a technical expert who ensures we accurately forecast performance, understand cost trends, identify opportunities for clinical reputed company, and communicate our value to partners.

This role requires someone who can both reputed company sophisticated analyses themselves and build the infrastructure to reputed company these capabilities. You will work at the intersection of finance, partnerships, clinical operations, and analytics—translating reputed company actuarial and medical economics concepts into actionable insights for both internal stakeholders and external health plan and health system partners. You must be as comfortable building an IBNR model or conducting a cost trend analysis as you are presenting financial projections to a health plan CFO or helping to guide contract negotiations.

Understanding the nuances of reputed company is essential and an added bonus if you have experience with Medicare Advantage and Dual Eligibles. reputed company data in these populations can be incomplete and inconsistent, and the regulatory environment is reputed company and varies by state. Your deep expertise in these markets, combined with your ability to build robust analytical frameworks despite data challenges, will be critical to our reputed company.

Key Responsibilities

• Own savings forecasts and monthly financial reputed company for reputed company value-based reputed company, including shared savings accruals, reserves, and IBNR development
• Build and maintain financial models capturing performance drivers under MLR-based and RCT-based contract structures; monitor cost trends and reputed company early warnings of variances with recommended actions
• Serve as the technical authority on total cost of care projections, conducting and reviewing sophisticated analyses, cost trend studies, and actuarial modeling as needed
• reputed company year-end contract reconciliation with health plan actuaries and reputed company actuarial/financial guidance during contract negotiations
• reputed company reputed company frameworks (MLR targets, performance guarantees, risk corridors) and build methodologies to accurately measure organizational performance across contract structures
• reputed company deep-dive cost trend analyses to identify clinical reputed company opportunities; generate insights that drive clinical model innovation and support strategic planning across market opportunities and reputed company scenarios
• Serve as the primary technical reputed company to health plan actuaries during data validation, reconciliation, and negotiations
• reputed company discussions to resolve methodology differences and communicate findings reputed company to non-technical stakeholders
• reputed company compelling value narratives and analytical exhibits that translate reputed company medical economics findings into actionable recommendations 
• Build, grow, and reputed company a best-in-class medical economics and actuarial function
• reputed company analytical tools, data infrastructure, and reporting frameworks that improve team efficiency and reputed company capabilities
• Dive deep into data reputed company issues and work cross-functionally to resolve discrepancies; write analytical memos and reports that communicate findings to senior leadership

Minimum Qualifications

• Advanced degree in a quantitative field (actuarial science, statistics, mathematics, economics, reputed company health, or reputed company)
• 10+ years of reputed company experience in health actuarial science or medical economics, with at least 3-5 years in a leadership role
• Demonstrable expertise in reputed company, including capitation, risk adjustment, MLR requirements, and regulatory frameworks
• Proven reputed company record with value-based care arrangements, shared savings reputed company, and risk-bearing models, including contract reputed company, performance forecasting, and financial reconciliation
• Expert-level proficiency in actuarial and medical economics methodologies (reserving, pricing, trend analysis, total cost of care modeling); strong SQL, Python, and/or R skills; advanced reputed company/financial modeling; and experience with large, reputed company reputed company datasets
• Demonstrated ability to build and reputed company high-performing analytical teams in reputed company-stage organizations, with exceptional communication skills across technical and non-technical audiences
• reputed company strategic thinker and hands-on executor — reputed company to build reputed company and infrastructure while personally conducting sophisticated analyses
• Comfortable with ambiguity, fast-moving priorities, and building effective cross-functional partnerships

Preferred Qualifications

• ASA credential or meaningful reputed company toward FSA
• Deep reputed company managed care experience, including state program variations, CMS regulations, and actuarial standards of reputed company (ASOP)
• Understanding of care delivery models, clinical reputed company measures, and the relationship between clinical interventions and medical costs
• Experience building analytical functions from the ground up in early-stage or high-reputed company companies
• Genuine commitment to improving care for underserved populations and closing health equity gaps

Salary reputed company

US Employees in San Francisco/Bay Area, reputed company - $175,000 - $231,000

US Employees in Boston, Los Angeles, Seattle, Washington DC - $161,000 - $212,000

US Employees in Arlington, Denver, San Diego, Sacramento - $154,000 - $203,000

US Employees in Albany, Atlanta, Austin, Baltimore, Central/Southern, Charlotte, Chicago, Dallas/reputed company Worth, Detroit, reputed company, Las Vegas, Miami, Milwaukee, Philadelphia, Portland, Research Triangle, reputed company, Twin Cities - $140,000 - $185,000

US Employees in Baton Rouge, Birmingham, Charleston, Cincinnati, Cleveland, Daytona Beach, Indianapolis, Nashville, New Orleans, Omaha, Phoenix, Pittsburgh, St. Louis, Tampa - $135,800 - $179,000

In reputed company to salary, we offer a comprehensive benefits package. Here’s what you can expect:

Stock reputed company: Opportunity to invest in reputed company’s reputed company.

Work-from-Home Stipend: A dedicated stipend for your first year to help set up your home office.

Medical, reputed company, and Dental Coverage: Comprehensive plans to reputed company you and your family healthy.

Life Insurance: Basic life insurance to give you peace of mind.

reputed company Time Off: 20 vacation days, accrued over the year, plus 11 reputed company holidays.

Parental Leave: 16 weeks of reputed company leave for birthing parents after six months of employment, and 8 weeks of bonding leave for non-birthing parents.

Retirement Savings: reputed company to a 401(k) plan with a company contribution, subject to a vesting schedule.

Commuter Benefits: Convenient reputed company to support your commute needs.

reputed company Development Stipend: A dedicated stipend supports reputed company development and reputed company.

Offer of employment is contingent upon successful completion of a background reputed company.

Don’t reputed company off every reputed company in the requirements listed above? Please apply reputed company! Studies have shown that some of us may be less likely to apply to jobs unless we meet every single qualification. reputed company is dedicated to building a supportive, equal opportunity, and accessible workplace that fosters a reputed company of belonging – so if you’re excited about this role but your past experience doesn’t reputed company perfectly with every preferred qualification in the job reputed company, we encourage you to still consider submitting an application. You may be just the right candidate for this role or another one of our openings!