Manager, Medical Economics

📋 Description

• Lead end-to-end membership reconciliation—enrollment, eligibility, capitation payments tracked
• Investigate and resolve membership and premium variances (retroactive changes, rate changes).
• Quantify revenue at risk and collaborate with internal teams and health plans to recover
• Build data flows and controls supporting member-month counts and premium accrual.
• Partner with Finance, Operations, and EIM to identify root causes and improve upstream data.
• Produce monthly reconciliation reports and dashboards for leadership visibility.

🎯 Requirements

• Bachelor’s degree in Statistics, Mathematics, Economics, CS, Healthcare Management, or related
• 7+ years in healthcare analytics, medical economics, or premium/membership reconciliation.
• Experience with healthcare, managed care, health plans, value-based care, or healthcare analytics.
• Strong expertise in Medicare Advantage, healthcare analytics, or medical economics.
• Understanding of PMPM, member months, capitation, premium accrual, and eligibility; experience with
• Advanced Excel; ability to analyze complex datasets and present findings to leadership.

🎁 Benefits

• Medical, dental, and vision coverage; employer-funded HSA/FSA; employer-paid life and disability
• Voluntary illness, accident, and hospitalization coverage; access to in-person and virtual care
• Competitive compensation; 401(k) with company match starting day 60; financial wellness resources.
• Up to 4 weeks PTO; 10 paid holidays; 2 volunteer days annually.