Senior Director of Medical Economics & Data Science

The Senior Director of Medical Economics & Data Science will lead the development and execution of data-driven strategies to optimize healthcare cost management, enhance patient outcomes, advance health equity, and support business growth. This individual will drive advanced analytics initiatives, leverage cutting-edge methods to provide deep insights into healthcare economics, utilization trends, and strategic decision-making. As a leader in this space, you will collaborate with cross-functional teams, including actuarial, clinical, operations, finance, and IT departments, to build innovative solutions that inform policy, improve operational efficiency, and promote evidence-based healthcare decisions.

ESSENTIAL JOB DUTIES AND RESPONSIBILITIES

• Strategic Leadership
  • Lead and oversee the development of analytical frameworks and models to assess healthcare utilization, costs, and outcomes.
  • Establish the vision, strategy, and roadmap for integrating machine learning and advanced analytics into medical economics initiatives.
  • Serve as a subject matter expert in data science methodologies, providing guidance on applying predictive analytics and AI techniques to complex healthcare data.
• Data-Driven Healthcare Economics
  • Analyze large datasets (e.g., Medicare claims, EMR, population health) to identify trends, cost drivers, and opportunities for intervention.
  • Design and implement machine learning models to predict risk and healthcare utilization patterns
  • Collaborate with actuarial teams on financial performance and profitability of products and services.
• Advanced Analytics & Machine Learning
  • Ensure scalability and accuracy of data pipelines, models, and analytics processes across the organization.
  • Partner with data engineering and IT teams to establish efficient data governance practices and to ensure access to reliable, high-quality data.
• Collaboration & Communication
  • Work closely with senior leadership to translate complex data insights into actionable business recommendations.
  • Collaborate with clinical teams to align analytics efforts with population health management, patient care improvement, and clinical efficiency goals.
  • Present findings and strategic insights to stakeholders at all levels of the organization, ensuring alignment with company goals.
  • Prioritize and sequence work to meet dynamic needs of our rapidly growing business
• Team Leadership & Development
  • Lead and mentor a high-performing team of data scientists, economists, and analysts.
  • Foster a culture of continuous learning and innovation, staying at the forefront of developments in machine learning, healthcare economics, and data science.Other duties as assigned.

SUPERVISORY RESPONSIBILITIES

This role has supervisory responsibilities for the Medical Economics and Analytics staff

REQUIRED PROFESSIONAL EXPERIENCE AND QUALIFICATIONS

• Minimum of 6+ years of experience in healthcare analytics, health services research, medical economics, or a related field, with at least 3-5 years in a leadership role.
• Proven track record of applying advanced analytics and machine learning techniques to solve complex healthcare problems.
• Experience working with Medicare claims, clinical data, and large population health datasets.
• Experience working in managed care and ACO/CMMI programs
• Proficiency in data science tools such as Python, R, SQL, and machine learning libraries
• Strong experience with data visualization and reporting tools (e.g., Tableau).
• Expertise in predictive modeling, statistical analysis, and machine learning algorithms.
• Knowledge of cloud-based data warehouse structure (e.g. AWS, Snowflake, etc.)
• Strong leadership skills with experience building and managing cross-functional teams.
• Excellent communication and presentation skills, with the ability to convey complex analytical concepts to non-technical stakeholders.
• Demonstrated ability to drive organizational change through data-driven decision-making.

PREFERRED PROFESSIONAL EXPERIENCE AND QUALIFICATIONS

• Knowledge of healthcare economics, actuarial analysis, and risk adjustment.
• Experience with conducting health services research and publishing peer-reviewed analyses

EDUCATION AND TRAINING

• Master’s or PhD in Data Science, Economics, Statistics, Health Economics, Computer Science, or a related field with a strong emphasis on quantitative methods and analytics is required.

LICENSE AND CERTIFICATION

• No license or certification is required for this role.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those encountered while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually quiet. Most of the work is performed on a computer and in a sedentary environment.

TRAVEL

This role may require some travel based on business needs.

SALARY RANGE

$150,000 - $175,000