Director, Medical Economics
Medical Home Network
Remote
Posted on May 2, 2025
Are you ready to join a passionate community of people who are changing how health care is delivered? A place where you will find a career you love while truly making a difference building healthier communities. If this sounds like you, we would love to have you apply as Director, Medical Economics, with Medical Home Network!
Founded in 2009 by the Comer Family Foundation, Medical Home Network unites health systems and providers around a vision to improve the health of patients and communities in Chicago. Today, as a Public Benefit Corporation (PBC), MHN has expanded its mission and impact to new markets and is a nationally recognized leader in transforming care within the safety net and building healthier communities across the country. Our whole person model of care, powered by proprietary technology, enhances collaboration across primary care and community-based organizations, leading to better outcomes, lower costs, and reduced health disparities.
THE OPPORTUNITY:
Reporting to the Vice President, FP&A, your experience and skills will play a pivotal role in identifying opportunities in cost and quality goals, developing financial models and expanding care management objectives of the organization. An ideal candidate will have an extensive background in medical economics, healthcare analytics, and value-based care.
THE PERKS
- Fun, challenging, and collaborative work environment with passionate colleagues that care deeply about healthcare delivery.
- Recognized as One of the Best Places to Work in Healthcare by Modern Healthcare.
- Competitive benefits programs including Medical, Vision, Dental, HSA, FSA, and 401k.
- Fitness reimbursement, commuter benefits, and tuition assistance.
- Great work life benefits- Paid time off, sick time, and 12 paid holidays.
- Hybrid schedule for candidates within 50 miles of Chicago, 2 days on site 3 days remote. Remote for candidates outside of this location.
WHAT YOU CAN LOOK FORWARD TO:
- Cost and Utilization Analysis:
- Analyze ACO REACH and MSSP program performance, including cost, utilization, and quality metrics.
- Identify opportunities for improvement in shared savings and financial performance.
- In partnership with the clinical teams, identify and implement strategies to reduce unnecessary medical expenditures without compromising patient care quality.
- Modeling & Reporting:
- Develop and maintain models for cost and utilization forecasting.
- Develop and oversee the creation of regular reports that provide the organization with financial performance, cost trends, and budget forecasts.
- Utilize predictive analytics to forecast future costs and assist in budgeting and planning.
- Support risk adjustment analyses and calculations.
- Stakeholder Engagement & Collaboration:
- Present findings, insights, and recommendations to senior leadership and other key stakeholders.
- Work closely with clinical and operational teams to implement strategies that enhance MSSP outcomes.
- Support care management programs by providing data-driven insights on high-cost and high-risk populations.
- Regulatory:
- Ensure that medical economics programs comply with healthcare regulations and industry standards.
- Identify financial risks associated with healthcare reimbursement and take proactive steps to mitigate them.
- Keep up to date with changing healthcare laws, regulations, and policies that affect medical economics.
WHAT YOU’LL NEED TO SUCCEED:
- Bachelor’s degree in healthcare economics, Statistics, Public Health, or a related field. Master’s degree preferred.
- 8+ years of experience in medical economics, related healthcare experience preferred in a managed care setting.
- Proven track record of working with MSSP programs, risk adjustment methodologies, and financial benchmarking process.
- Experience analyzing healthcare quality metrics (e.g., HEDIS, STAR ratings, ACO performance).
- Demonstrated experience with value-based care and risk sharing arrangements, including bundled payments and shared savings models.
- Strong proficiency in data analysis tools and economic modeling software
- Knowledge of healthcare reimbursement models and alternative payment structures.
- Excellent communication and presentation skills, with the ability to collaborate across multidisciplinary teams.
- Strong project management and problem-solving abilities.
- Previous actuarial experience preferred
- Strong understanding of population health management principles
Medical Home Network is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.