Director, Medical Economics

Job Summary

The Director of Medical Economics provides rigorous analytical support for evaluating value-based care impact across clinical, financial, operational, quality, utilization, patient experience, and health-equity outcomes. The role translates strategic priorities into analytical workplans, develops and executes healthcare analyses, and delivers clear, reliable findings to support strategic decision-making and demonstrate measurable impact.

Key Responsibilities

• Translate strategic priorities into analytical plans, data requirements, metrics, and evidence frameworks.
• Develop and execute analyses of clinical, financial, operational, quality, utilization, patient experience, and health-equity performance.
• Apply attribution, risk adjustment, benchmarking, trend analysis, cohort comparison, and program evaluation methods.
• Apply causal inference and quasi-experimental study designs to evaluate healthcare interventions.
• Identify and quantify key drivers of cost, utilization, quality, clinical outcomes, and other performance measures.
• Develop recurring measurement approaches for consistent impact evaluation.
• Prepare analytical exhibits, reports, summaries, and supporting materials for technical and non-technical stakeholders.
• Clearly communicate analytical findings, methodological assumptions, limitations, and confidence in conclusions.
• Collaborate with actuarial, clinical, finance, operations, product, network, growth, and data teams.
• Maintain analytical workplans, documentation, governance, and reusable measurement standards.
• Respond to ad hoc analytical questions and provide timely, decision-ready analyses.
• Ensure analyses are rigorous, reproducible, well-documented, and aligned with strategic objectives.

Required Qualifications

• 7+ years of progressive experience in medical economics, healthcare analytics, actuarial analysis, outcomes research, population health, value-based care, or a related field.
• Strong understanding of value-based care programs and healthcare claims, clinical, financial, quality, and operational data.
• Experience with relational databases and statistical programming.
• Experience evaluating healthcare interventions using comparative, longitudinal, or other rigorous evaluation methods.
• Strong knowledge of causal inference and quasi-experimental study design.
• Experience with attribution, risk adjustment, benchmarking, trend analysis, program evaluation, and financial impact measurement.
• Strong analytical, methodological, and problem-solving skills.
• Ability to explain complex analytical methods and findings to technical and non-technical audiences.
• Experience collaborating across clinical, actuarial, finance, analytics, operations, product, network, or commercial teams.
• Bachelor's degree in economics, statistics, mathematics, public health, health services research, actuarial science, business, data science, or a related discipline.
• Experience with Medicaid managed care is preferred.

Virginia, Virginia, United States

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