Source Job

$150,000–$180,000/yr
US

  • Own total cost-of-care analytics across payer contracts, including PMPM, utilization, and shared savings calculations.
  • Build and maintain internal and external reporting infrastructure, from payer-facing dashboards to trend reports.
  • Lead AI strategy for medical economics, developing agentic workflows for claims analytics and care pathway identification.

Data Analytics Reporting AI Claims Analysis

20 jobs similar to Director of Medical Economics

Jobs ranked by similarity.

US

  • Own the central analytics function, defining metric logic and quality standards across claims and operational data.
  • Build standard reporting packages and executive dashboards, track contract performance, and establish the clinical analytics surface.
  • Make business units self-sufficient by setting standards and documentation, ensuring consistent definitions across the company.

Chamber is rebuilding the cardiology system by partnering with independent cardiologists, using technology and data to improve patient outcomes. It is a fast-paced startup with a culture of empathy, ownership, and grit.

$180,000–$210,000/yr
US

  • Drive strategic partnerships with national payers to accelerate growth and expand access to value-based cancer care.
  • Lead cross-functional collaboration with Clinical Operations, Finance, and Product to manage payer relationships from opportunity analysis through contracting.
  • Own the full sales cycle including RFP processes, contract negotiations, and operational handoffs to ensure long-term success.

Daymark Health is a value-based oncology company redefining the cancer care experience for patients, providers, and health plans. Backed by several venture capital firms and led by CEO Dr. Justin Bekelman, the company is a pioneering startup in cancer care.

$160,000–$180,000/yr
US

  • Lead the design, development, and lifecycle management of analytical and automation products for payer health plans.
  • Translate market needs and customer insights into product capabilities that improve health plan performance and cost management.
  • Partner cross-functionally with Engineering, Data Science, and Sales to drive product strategy and commercial success.

MedeAnalytics is an enterprise healthcare performance company that delivers AI-driven cloud solutions to payers and providers. With over 30 years of industry experience, the company fosters a culture of innovation and impact.

US 12w maternity 12w paternity

  • Lead the care, case, and utilization management programs, setting clinical direction and owning performance targets.
  • Evolve clinical operating models and partner with Product and Engineering to integrate AI tools into workflows.
  • Manage, develop, and retain clinical leaders while collaborating cross-functionally to coordinate care for members.

Included Health is a healthcare company delivering integrated virtual care and navigation. They are on a mission to raise the standard of healthcare for everyone, with a remote-first culture and a focus on breaking down barriers to high-quality care.

US 12w maternity 12w paternity

  • Lead care management programs with strategic and operational oversight.
  • Drive clinical performance metrics and evidence-based care models.
  • Collaborate with cross-functional teams to integrate AI and improve population health.

The partner company is a healthcare organization focused on care management and population health. It operates with a remote-first culture and offers opportunities to influence innovative healthcare models.

US

  • Develops and implements new business plans and strategies, identifies opportunities, and leads execution of projects, people, and pursuits for the HI Program.
  • Provides strategic leadership in health economics, healthcare delivery and payment reform, and data analytics, serving as a subject matter expert.
  • Builds and maintains relationships with clients, partners, and staff, representing AIR and driving program growth and operational goals.

American Institutes for Research (AIR) is a nonpartisan, not-for-profit organization that conducts behavioral and social science research and delivers technical assistance to address pressing challenges in the US and globally. Founded in 1946 and headquartered in Arlington, Virginia, AIR has a large workforce and a culture focused on evidence and data-driven solutions.

US

  • Lead HEOR evidence strategy and economic models for precision diagnostics across CKD and transplant.
  • Develop real-world and trial evidence, publications, and payer value communications.
  • Collaborate cross-functionally with Medical Affairs, Biostatistics, Market Access, and Commercial partners.

Natera is a global leader in cell-free DNA (cfDNA) testing, focusing on oncology, women's health, and organ health. Its team of scientists, clinicians, and business professionals works to make personalized genetic testing part of standard care.

US 3w PTO

  • Analyze claim selection processes and AI-enabled methodologies to optimize payment integrity outcomes.
  • Collaborate with data scientists and analytics teams to validate coding and reimbursement accuracy.
  • Serve as subject matter expert in healthcare billing, coding, and regulatory compliance.

Cotiviti is a healthcare payment integrity company that leverages data and AI to improve claim accuracy and compliance. They are a large organization with a collaborative culture focused on innovation and operational excellence.

$93,392–$149,156/yr
US 5w PTO

  • Lead value analysis initiatives to improve healthcare operations and cost-effectiveness.
  • Analyze contracts, costs, and product specifications to drive standardization and savings.
  • Manage cross-functional projects and facilitate value analysis committees.

A healthcare operations partner focused on value analysis and supply chain optimization. They offer a fully remote work environment and a comprehensive benefits package.

US

  • Develop and maintain risk-adjusted provider group performance models using CMS-HCC methodology.
  • Analyze large healthcare datasets, including Medicare claims (CCLF and BCDA), to monitor financial performance.
  • Create executive dashboards and present findings to leadership and clinical stakeholders.

Ennoble Care is a mobile primary care, palliative care, and hospice service provider serving patients across multiple US states. They provide in-home care for chronic conditions and limited mobility, with a culture driven by the motto 'To Care is an Honor.'

$95,000–$121,000/yr
US 3w PTO

  • Apply deep clinical, coding, and reimbursement expertise to enhance AI-enabled claim selection tools.
  • Partner with data science teams to validate AI outputs and improve model performance.
  • Serve as a coding subject matter expert to support audit concept development and optimization.

Cotiviti is a healthcare analytics company specializing in payment integrity and data-driven solutions. The company fosters a collaborative culture and emphasizes innovation in healthcare audit and analytics.

US

  • Lead clinical programming and quality initiatives, including Stars/HEDIS strategy and risk coding documentation improvement.
  • Collaborate with Product, Engineering, and Analytics to design AI-enabled clinical tools and workflows.
  • Drive data-driven outcomes by monitoring metrics and identifying opportunities for intervention and improvement.

Chamber Cardio rebuilds the cardiology system by partnering with independent cardiologists to improve population health through technology, data, and operational tools. They are a mission-driven organization focused on innovation and empathy, blending clinical expertise with modern operating platforms.

$175,000–$215,000/yr
US Unlimited PTO 8w maternity 8w paternity

  • Drive strategic insight and operational rigor across the Commercial organization while building and scaling the Value Consulting function.
  • Own core GTM and RevOps strategy, lead cross-functional initiatives, and create methodology and playbooks for value-selling.
  • Engage on strategic deals, renewals, and EBRs with data-backed value cases, and train AEs and CSMs on value-selling tools.

AcuityMD is a software and data platform that accelerates access to medical technologies by helping MedTech companies understand product usage and identify opportunities. Backed by Benchmark, Redpoint, ICONIQ Growth, and Ajax Health, it is a high-growth, remote-first company with a focus on collaboration and inclusion.

US

  • Architect and scale a unified Central Operations hub for dual-revenue engine optimization, including Fee-For-Service and Value-Based Care workflows.
  • Own ancillary services such as Medical Records, Lab Integrations, and Referral Management while driving facility partner onboarding and B2B integration.
  • Oversee telemedicine team deployment for footprint support and create executive dashboards to monitor provider productivity and operational outcomes.

Theoria Medical provides telemedicine and operational services to post-acute care facilities, including skilled nursing and assisted living communities. The company is scaling a centralized operations hub to support multi-state growth, though specific employee size is not disclosed.

US 4w PTO 12w maternity 12w paternity

  • Oversee sales engineering, solution design, and deal support to maximize revenue for providers and Aledade.
  • Lead a team of SMEs in data analytics, financial modeling, and process documentation.
  • Coordinate cross-functional meetings and strategic initiatives to drive growth and operational leverage.

Aledade is a public benefit corporation that empowers independent primary care practices to thrive in value-based care. Founded in 2014, we are the largest network of independent primary care in the country, with a collaborative, inclusive, and remote-first culture.

US

  • Support development and operationalization of scalable real-world data platforms for evidence generation.
  • Partner with HEOR and medical teams to translate strategic evidence needs into data platform requirements.
  • Contribute to linked longitudinal data capabilities and data quality frameworks for robust RWE studies.

Novartis is a global pharmaceutical company dedicated to improving lives through innovative science. With a large workforce, they foster an inclusive culture that empowers collaboration and bold innovation.

$90,440–$133,000/yr
US Unlimited PTO 16w maternity 16w paternity

  • You will own the production of commercial KPIs and competitive intelligence resources for the payer commercial team.
  • You will drive coordination of commercial reporting cycles and enablement infrastructure for the payer partnerships org.
  • You will work on critical strategic workstreams that power the commercial operating system, using AI tools to enhance outputs.

Headway is building a new mental healthcare system by automating insurance-related admin work for providers, making therapy accessible and affordable. As a Series D company with over $325M in funding and 75,000+ providers on their platform, they foster a culture of impact, innovation, and using AI to rewire mental healthcare.

US Unlimited PTO

  • Leads paid media acquisition strategy across search, social, and programmatic channels.
  • Drives consumer acquisition and conversion for digital marketing and ecommerce offerings.
  • Manages agency relationships, budgets, and cross-functional partners to scale growth programs.

Healthequity empowers healthcare consumers to save and improve lives. The company is a growing firm with a culture focused on collaboration, ownership, and continuous improvement, offering benefits like uncapped PTO and parental leave.

US 3w PTO

  • Interpret and assess payment policy and medical coding guidelines to maintain and develop the medical policy library.
  • Conduct thorough research and multi-faceted analytics to identify opportunities and ensure policy accuracy.
  • Collaborate with client-facing teams and internal stakeholders to educate on policy updates and drive quality.

Cotiviti is a healthcare analytics company focused on payment accuracy and quality improvement solutions. The company maintains a collaborative culture and values innovation, though its size is not specified.

US

  • Define and own product strategy for payer solutions, translating customer needs into actionable roadmaps.
  • Conduct market analysis and competitive research to identify opportunities.
  • Develop product positioning, pricing, and go-to-market plans.

The company specializes in healthcare data analytics and intelligence solutions for payer organizations. It offers a flexible, remote-first culture with a focus on professional development and innovation.