Senior Health Care Economics & Value-Based Analyst

Enlace Health•Atlanta, GA

About The Position

Senior Health Care Economics & Value-Based Analyst Enlace Health is a specialty value-based care company focused on reducing the cost of care where it matters most: specialty services. Enlace operates across 80+ markets, delivering measurable results including millions in savings and improved care coordination. Our platform embeds actionable intelligence into real-world execution, helping payors lower medical loss ratios and drive sustainable financial performance. At Enlace Health, our people are our greatest asset. Our culture is founded upon integrity, hard work, and the relentless pursuit to make a difference. We think creatively, we like a challenge and draw inspiration from each other. As the Senior Health Care Economics & Value-Based Analyst, you’ll have deep expertise in actuarial methods, value-based payment modeling, predictive analytics, and medical cost economics. This role will support the design, evaluation, and optimization of value-based pricing and performance frameworks across Commercial, Medicare (including Medicare Advantage), and Medicaid populations. The ideal candidate combines actuarial discipline (MAA/ASA track preferred), advanced statistical modeling expertise, and strong hands-on data capability (SQL, Tableau, Excel), with experience operating in complex payer and provider environments. Success Measures: In 3 months: Gain full command of data, methodologies, and value-based program mechanics. Deliver early validated insights that build stakeholder confidence. In 6 months: Translate analytics into actionable financial and clinical insights. Own development of methodologies for program evaluation, performance normalization, and predictive insights for value-based programs. In 12 months: Architect scalable value-based pricing and performance frameworks. Inform network, contracting, clinical, and financial decisions with advanced analytics. Demonstrate measurable enterprise impact on cost, quality, and risk performance.

Requirements

Bachelors degree in a STEM field (Statistics, Mathematics, Economics, Engineering, Computer Science, or related), with Master’s degree preferred (Health Economics, Data Science, Biostatistics, Applied Statistics, or related quantitative discipline), or equivalent work experience
5+ years of experience working within a payer or provider organization, or with healthcare analytics or care management organizations
Demonstrated experience across Commercial, Medicare (including MA), and Medicaid populations
Deep experience working the following types of data: Medical claims data Enrollment and eligibility data Provider data CMS revenue and risk adjustment data Value-based performance datasets Familiarity with EMR/EHR and SDOH
Strong proficiency in SQL, Tableau, and Excel

Nice To Haves

Experience utilizing Python or R is a plus

Responsibilities

Develop actuarially sound pricing models for Episodes of Care/Bundled Payments, Total Cost of Care (TCOC) programs, Shared Savings/Shared Risk arrangements, and sub-capitation and specialty value-based programs
Construct prospective and retrospective target-setting methodologies using difference-in-differences approaches, market benchmarking, credibility weighting, and risk-adjusted baselines
Evaluate financial and quality performance across Commercial, Medicare Advantage, and Medicaid lines of business
Support pricing validation, reconciliation modeling, and performance evaluation analyses
Develop and operationalize predictive models for cost, utilization, quality outcomes, and performance evaluation using random forest, gradient boosting (preferred), propensity score matching, logistic regression/GLMs, and/or multivariate and hierarchical modeling
Build provider performance classifiers and volume-based credibility frameworks
Conduct contracted vs. non-contracted provider performance comparisons
Support steerage, network optimization, and care management analytics
Perform medical cost trend decomposition (unit cost vs. utilization vs. intensity vs. mix)
Conduct risk-adjusted PMPM analysis across specialties, site-of-service, and population segments
Analyze longitudinal performance across defined assessment periods
Quantify impact of specialty utilization patterns and referral dynamics
Evaluating acuity, case-mix, and coding impacts across populations
Write advanced SQL queries to construct episode-level, provider-level, and member-month datasets
Develop repeatable analytic workflows supporting production modeling
Build executive-facing dashboards in Tableau
Construct Excel-based financial models for pricing and reconciliation analyses