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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.

SQL Excel Data Analytics

20 jobs similar to Sr. Medical Economics Analyst

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$130,000–$160,000/yr
US Unlimited PTO 12w maternity 12w paternity

  • Own the program's analytics pipeline including claims records, eligibility files, and MAO-004 reconciliation across all clients.
  • Lead care-gap identification and closure reconciliation, ensuring accuracy for billing and client audits.
  • Deliver practice-level performance analysis and build funnel instrumentation to identify value leakage.

Covera Health combines clinical expertise, advanced AI, and radiology quality data to improve diagnostic accuracy. Backed by Insight Partners, the company supports nearly 6 million people across major employers and health plans, with a culture focused on meaningful work and saving lives.

US

  • Analyze medical and pharmacy claims data to identify trends, cost drivers, and opportunities for optimization.
  • Support provider contracting and payer teams by pulling data on reimbursement models, pricing structures, and fee schedules.
  • Build and maintain reports and dashboards using SQL, Power BI, or Tableau to visualize key business metrics.

Nomi Health is rebuilding the healthcare system to make it clear, fast, and data-driven, touching over 30 million lives. The company is a team of 300+ people who challenge the system and build better solutions together.

$80,000–$125,000/yr
US Unlimited PTO

  • Own the investigation and resolution of data observations and data questions from internal and external stakeholders.
  • Define and track quality metrics, build dashboards, and identify improvement opportunities for data products.
  • Collaborate with Product Managers, Engineers, and QA to launch new features that improve data at scale.

Veeva Systems is a mission-driven organization and pioneer in industry cloud, helping life sciences companies bring therapies to patients faster. As one of the fastest-growing SaaS companies in history, we surpassed $3B in revenue in our last fiscal year with extensive growth potential ahead.

US

  • Support the in-house build of cost categorization capability and own ongoing maintenance and governance.
  • Build and maintain medical economics reporting suite and analyze medical cost trends.
  • Partner across Clinical, Operations, and Finance to translate business questions into analyses.

Hopscotch Primary Care provides high-quality primary care tailored to rural communities, aiming to make healthcare accessible to all. We are a growing team serving thousands of patients with a value-based care model, fostering a culture of inclusion and teamwork.

  • Translate risk adjustment performance data into clear financial insights, including revenue impact, payment accuracy, ROI, and forecasting.
  • Analyze CMS data to identify opportunities for increasing operational efficiency and interpret trends to assess program and policy impacts.
  • Prepare and deliver clear reports and presentations to senior leadership, translating technical findings into actionable business recommendations.

Strive Health is on a mission to transform chronic conditions by identifying risk earlier and coordinating thoughtful care to reduce emergency visits and improve outcomes. The company offers a hybrid-remote flexibility model with comprehensive benefits and a culture described as passionate, one-team oriented, and focused on making an impact.

$81,000–$95,000/yr
US

  • You will deliver high-value analysis and reports by collaborating with cross-functional teams like BI, IT, Quality, and Operations.
  • You will manage performance evaluations, incentive payment distributions, and leading indicator analyses for Value-Based Contracts.
  • You will convert business requirements into technical specs, write SQL queries, and partner with Data Engineering to ensure data quality.

Privia Health is a technology-driven national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices and improve patient experiences. The company is led by top industry talent and exceptional physician leadership, fostering a collaborative and innovative culture.

US

  • Design and execute observational research studies using healthcare data to evaluate clinical program impacts.
  • Extract and analyze large healthcare datasets with SQL and Python, building reproducible analytic workflows.
  • Translate statistical findings into actionable insights for clinical, operational, and executive stakeholders.

Curana Health is a national leader in value-based care, providing solutions to senior living communities and skilled nursing facilities to enhance health outcomes and streamline operations. Founded in 2021, the company has grown to serve over 200,000 seniors in 1,500+ communities across 32 states with a team of more than 1,000 clinicians and professionals.

US

  • Leverage 6+ years of data analysis expertise in a healthcare setting.
  • Apply deep knowledge of SQL, Python, and Databricks for data validation and reporting.
  • Utilize experience with Claims, Membership, or Clinical data to drive insights.

This company is a technology-enabled services firm that connects skilled professionals with healthcare projects. They focus on high-impact data initiatives and value a collaborative, quality-driven culture.

$150,000–$185,000/yr
US

  • Build and maintain member-level actuarial models for risk adjustment, HCC capture, and medical economics across MA, MAPD, ACA, and Medicaid populations.
  • Design actuarial logic for customer-facing dashboards, partnering with data engineering and product teams to deliver accurate, timely visualizations.
  • Support RADV readiness by modeling audit exposure and prioritizing chart review efforts based on financial impact.

Reveleer delivers a unified platform spanning risk adjustment, quality improvement, clinical intelligence, and member management for health plans and provider organizations navigating value-based care. Trusted by over 80 customer organizations nationwide, the platform integrates data, analytics, and intelligent workflow automation into one governed system.

$140,000–$170,000/yr
US Unlimited PTO

  • Collaborate with clients and internal stakeholders to understand payment integrity requirements and integrate analytical outputs.
  • Drive AI adoption by prompting LLMs and building automated workflows to accelerate analysis.
  • Write and maintain complex analytical SQL, including window functions and CTEs, against large-scale healthcare claims datasets.

Machinify is a leading healthcare intelligence company that delivers value and efficiency to health plan clients. Deployed by over 85 health plans representing more than 270 million lives, the company fosters a culture of innovation and disruption.

$114,300–$127,000/yr
US

  • Own HIPAA-compliant source-of-truth artifacts governing Medicare claims business rules.
  • Validate changes internally and communicate updates to external CMS stakeholders.
  • Bridge product and engineering by translating policy needs into clear requirements.

Nava is a consultancy and public benefit corporation working to make government services simple and effective. Since 2015, they have helped federal, state, and local agencies solve technology modernization challenges, and they are a remote-first team with a collaborative culture.

$73,539–$136,065/yr
US

  • Analyze large datasets to identify trends and insights that drive business decisions, using Looker for automated reporting.
  • Collaborate with business leaders to provide actionable recommendations and evolve from descriptive reports to proactive data-driven improvements.
  • Design data models, utilize statistical techniques, and mentor junior analysts to foster a data-driven culture.

PatientPoint is a leading digital health company that connects patients, healthcare providers, and life sciences companies with the right information at the moment of care. With over 750 million patient visits annually across 35,000 physician offices, they are a purpose-driven team committed to improving health outcomes.

US

  • Provide expert advice on model evaluation design to align with policy goals and statutory requirements.
  • Conduct data analyses including prevalence studies, power calculations, and cost/quality measurement.
  • Bridge policy, model design, and evaluation to inform trade-offs and ensure rigorous certification.

ORAU provides scientific and technical support to help federal agencies achieve their missions. As an employee-owned company with a focus on culture, ORAU offers part-time, temporary roles like this one for the CMMI project.

US 4w PTO 12w maternity 12w paternity

  • Own strategy and execution for go-to-market efforts across Aledade's Risk Stratification program.
  • Build strategic partnerships with payer partners and large practice leaders to advance accurate diagnosis documentation.
  • Coordinate cross-functional teams and provide expertise to drive risk stratification initiatives.

Aledade is a public benefit corporation that empowers independent primary care. Founded in 2014, it has become the largest network of independent primary care in the country, fostering a collaborative and remote-first culture.

$65,000–$75,000/yr
US 4w PTO

  • Transform complex healthcare data into actionable insights across claims, clinical, and member data domains.
  • Collaborate with analysts to define analytical approaches and support operational and clinical decision-making.
  • Work with SQL and Python to query, wrangle, and analyze complex datasets, supporting ad hoc deep dives.

Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic, and comprehensive approach. The company is committed to improving patient outcomes and quality of life by delaying disease progression, shifting care to the home, and accelerating kidney transplants, fostering a collaborative and innovative culture.

$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.

$120,000–$160,000/yr
Global Unlimited PTO

  • Engage directly with clients to provide advanced analytical support for pricing consultations and AI model adoption.
  • Write and execute SQL and Python queries to analyze large datasets and evaluate submission performance.
  • Clearly communicate complex mathematical and AI concepts to non-technical client stakeholders.

Gradient AI revolutionizes Group Health and P&C insurance with AI-powered solutions that help insurers predict risk more accurately, improve profitability, and automate underwriting and claims. Backed by $56M in Series C funding and scaling rapidly since 2018, the company fosters a fun, team-oriented startup culture.

$94,000–$116,000/yr
US 3w PTO

  • Lead sophisticated data analysis to uncover trends, mitigate risks, and unlock opportunities.
  • Conduct market research and competitive analysis to drive strategic initiatives.
  • Mentor junior analysts and champion process optimization for business transformation.

Cotiviti Healthcare is a leader in payment accuracy services, serving top-tier companies in healthcare and retail. They have a dynamic team of problem solvers focused on revolutionizing healthcare systems.

$130,000–$150,000/yr
US 4w PTO

  • Reporting & Monitoring: Build and maintain AWS QuickSight dashboards tracking product health, KPIs, and growth.
  • Ad-hoc Analysis: Scope and deliver ad-hoc reports and analyses for internal stakeholders.
  • AI-Enabled Reporting: Apply AI across the reporting function, including automated narrative summaries and self-serve query tools.

DrFirst is a thriving Healthcare IT company with established products, prestigious clients, and continuous growth. The culture is entrepreneurial, collaborative, and fast-paced, ideal for those seeking personal and professional growth.

$115,000–$152,500/yr
US

  • Act as a business partner to Customer Excellence leaders, leading projects to develop answers to key business questions.
  • Present insights to executives to drive performance improvements and establish scalable process enhancements.
  • Mine large datasets, draw relevant insights, and create visualizations for executive consumption.

Smartsheet provides a cloud-based platform for work execution, enabling teams to plan, track, automate, and report on work at scale. The company has been operating for over 20 years and fosters an inclusive culture focused on innovation and employee growth.