Director, Medical Economics

Position: Director, Medical Economics

The Director, Medical Economics is a strategic leadership role responsible for driving financial, clinical, and client performance across Monogram's value-based care programs. This individual will lead a small team and partner closely with Clinical, Operations, Actuarial, Finance, Client Partnerships, and Reporting to identify, quantify, and operationalize opportunities that reduce medical cost, improve quality outcomes, and optimize contract performance.

The Director will translate complex healthcare claims, utilization, and operational data into actionable business insights. This role will serve as a key thought partner to organizational leadership, providing decision support for strategic initiatives, client performance reviews, and enterprise growth efforts.

The ideal candidate combines strong healthcare analytics expertise with business acumen, leadership capability, and the ability to influence decisions across a highly matrixed organization.

Roles and Responsibilities

• Lead analytics on medical expense, medical loss ratio (MLR), utilization, quality, and pharmacy performance across value-based care contracts
• Support client-facing materials and reporting, executive reviews, and board-level analytics
• Oversee development and evolution of key Medical Economics reporting assets, dashboards, and performance management tools, ensuring reporting is accurate, actionable, and aligned with organizational objectives
• Drive governance and continuous improvement of analytical methodologies and business definitions
• Quantify expected and realized financial impacts of enterprise initiatives
• Partner with departments such as IT and Finance ensuring appropriate data structure and reporting
• Serve as a trusted advisor to senior leadership, clinical leaders, operations, client partnerships, and finance
• Translate technical findings into concise executive-level recommendations
• Create an environment conducive to growth by creating scalable and flexible solutions to data challenges
• Lead ad hoc and strategic analytical projects, with the ability to prioritize tasks, in a dynamic and evolving organization

Position Requirements

• Bachelor’s degree in finance, mathematics, statistics, Actuarial Science, economics, or related field
• Actuarial designation (ASA or FSA) preferred
• Minimum of 5 years previous experience working in a value-based provider group and/or health plan
• Minimum of 2 years previous experience coaching, leading, and hiring a top performing team is also required. This includes coaching individual performance, hiring, resource recruitment and bandwidth management
• Highly proficient in Microsoft Excel, SQL, and various reporting tools
• Experience with Databricks, Power BI, or large-scale healthcare data platforms
• Deep understanding of healthcare claims, utilization management, risk adjustment, value-based care, and population health performance measurement
• Advanced analytical and problem-solving skills with the ability to synthesize large datasets into business recommendations
• Experience communicating findings to executive audiences
• Demonstrated ability to manage multiple priorities in a fast-paced environment
• Medicare Advantage experience strongly preferred
• Experience supporting value-based arrangements, shared savings models, or risk-based contracts preferred

Benefits

• Comprehensive Benefits - Medical, dental, and vision insurance, employee assistance program, employer-paid and voluntary life insurance, disability insurance, plus health and flexible spending accounts
• Financial & Retirement Support – Competitive compensation, 401k with employer match, and financial wellness resources
• Time Off & Leave – 20 PTO days, 7 paid holidays, and 1 floating day to make your own, and paid parental leave
• Wellness & Growth – Work life assistance resources, physical wellness perks, mental health support, employee referral program, and BenefitHub for employee discounts 

About Monogram Health

Monogram Health is a next-generation, value-based chronic condition risk provider serving patients living with chronic kidney and end-stage renal disease and their related metabolic disorders. Monogram seeks to fill systemic gaps and transform the way nephrology, primary care and chronic condition treatment are delivered. Monogram’s innovative, in-home approach utilizes a national nephrology practice powered by a suite of technology-enabled clinical services, including case and disease management, utilization management and review, and medication therapy management services that improve health outcomes while lowering medical costs across the healthcare continuum. By focusing on increasing access to evidence-based care pathways and addressing social determinants of health, Monogram has emerged as an industry leader in championing greater health equity and improving health outcomes for individuals with chronic kidney and end-stage renal disease.

At Monogram Health we believe in fostering an inclusive environment in which employees feel encouraged to share their unique perspectives, leverage their strengths, and act authentically. We know that diverse teams are strong teams, and welcome those from all backgrounds and varying experiences.