Manager, Medical Economics

Matter Healthcare • Nashville, TN

1d

About The Position

The Manager, Medical Economics owns Matter Health's membership and premium reconciliation functions, ensuring enrollment, eligibility, and capitation revenue accurately reconcile across payer files, internal systems, and financial reporting processes. This individual will serve as the subject matter expert for membership and premium economics, partnering closely with Finance, Enterprise Information Management (EIM), and Operations to identify discrepancies, recover revenue at risk, and improve data accuracy and integrity across the organization. The ideal candidate combines strong healthcare analytics experience with managed care knowledge and thrives in a fast-paced, high-growth environment.

Requirements

• Bachelor's degree in Statistics, Mathematics, Economics, Computer Science, Healthcare Management, or a related field required.
• 7+ years of experience in healthcare analytics, medical economics, or premium/membership reconciliation.
• Experience working within healthcare, managed care, health plans, value-based care organizations, or healthcare analytics environments.
• Strong experience with Medicare Advantage, healthcare analytics, and/or medical economics.
• Demonstrated understanding of healthcare financial concepts including PMPM, member months, capitation, premium accrual, and eligibility concepts.
• Experience working with enrollment and eligibility data, including payer files such as 834/820 transactions.
• Advanced Excel skills and the ability to independently analyze complex datasets.
• Experience presenting analytical findings and recommendations to leadership.
• Strong analytical, problem-solving, communication, and relationship-building skills.

Nice To Haves

• SQL experience.
• Experience with premium reconciliation processes.
• Managed care organization experience.
• Experience building dashboards in Power BI and/or Tableau.
• Knowledge of value-based care analytics and risk-based reimbursement models.
• Previous leadership or team management experience.

Responsibilities

• Own the end-to-end membership reconciliation process, ensuring enrollment, eligibility, and capitation payments reconcile accurately across payer files, internal systems, and the general ledger.
• Investigate and resolve membership and premium variances, including retroactive additions, terminations, and rate changes.
• Quantify revenue at risk and partner with internal teams and health plans to recover discrepancies.
• Build and maintain business rules, controls, and data flows supporting member-month counts and premium accrual processes.
• Partner closely with Finance, Operations, and Enterprise Information Management teams to identify root causes and implement upstream data improvements.
• Produce monthly reconciliation reporting and dashboards that provide leadership visibility into membership, PMPM, and premium trends.
• Support month-end close activities by validating premium revenue and explaining membership and premium variances.
• Conduct independent analyses and present findings and recommendations to leadership.
• Help establish scalable reconciliation processes and prepare to support future analyst team growth.

Benefits

• Medical, dental, and vision coverage
• Employer-funded HSA and FSA options
• Employer-paid life and disability insurance
• Voluntary illness, accident, and hospitalization coverage
• Access to Matter Health’s in-person and virtual care services
• Competitive compensation
• 401(k) with company match beginning at day 60
• Access to financial wellness resources and support
• Up to 4 weeks of PTO
• 10 paid company holidays
• 2 volunteer days annually to support causes meaningful to you

What This Job Offers

• Job Type: Full-time
• Career Level: Manager