Manager Medical Economics

Responsibilities

• Own the creation and development of clinical impact reporting, including infrastructure, methodology, and narratives for payers, partners, and leadership.
• Build and maintain SQL-based analytic processes and dashboards across medical claims, pharmacy claims, enrollment, and attribution data.
• Lead analyses of cost trends, utilization impact, clinical effectiveness, and economic and operational efficiency.
• Define how Chamber measures success and communicates its health economics story.
• Partner with senior executives to provide evidence for strategic decisions.
• Scale the Medical Economics team and analytical platform as the contract portfolio grows.
• Turn incomplete or ambiguous data and requests into defensible, actionable outputs.
• Use SQL, Excel, AI tools such as Claude, and PowerPoint to create rigorous, accessible analyses.

First 90 Days

• Audit the health economics data landscape, document gaps, and establish a prioritized remediation roadmap.
• Develop and enhance reporting and dashboards for current risk contracts.
• Deliver cohort efficacy reporting on Transitions of Care and Medication Adherence, including inpatient utilization and medication therapy impact.
• Present a performance review to senior leadership covering data reliability, analytical gaps, and priorities for the next quarter.

Requirements

• At least 4 years of experience in medical economics, health economics, or a related analytics or actuarial role.
• Fluency with value-based care performance metrics, including TCOC, avoidable inpatient utilization (APK), utilization benchmarks, quality measures, medication adherence, and economic efficiency indicators.
• Proficiency in SQL, Excel, and PowerPoint, with comfort using AI prompting tools in analytical workflows.
• Familiarity with CMS value-based care models such as MSSP and REACH, CMS-HCC risk adjustment, and CMS quality scores.
• Ability to own analytical work end-to-end, from hypothesis formation and analysis design through communication of findings.
• High tolerance for ambiguity and ability to produce clear, defensible, useful outputs from messy data and unclear briefs.
• Strong written and verbal communication skills, including presenting complex findings to senior executives.
• Critical thinking and a scrappy, ownership-oriented operating style.
• Bachelor’s degree in health economics, public health, biostatistics, or a related field.

Compensation and Benefits

• No compensation information was provided.