Staff Medical Economics Analyst

HomewardChicago, IL
11d$135,000 - $160,000

About The Position

Homeward is rearchitecting the delivery of health and care in partnership with communities everywhere, starting in rural America. Today, 60 million Americans living in rural communities are facing a crisis of access to care. In the U.S. healthcare system, rural Americans experience significantly poorer clinical outcomes. This trend is rapidly accelerating as rural hospitals close and physician shortages increase, exacerbating health disparities. In fact, Americans living in rural communities suffer a mortality rate 23 percent higher than those in urban communities, in part because of the lack of access to quality care. Our vision is care that enables everyone to achieve their best health. So, we’re creating a new healthcare delivery model that is purpose-built for rural America and directly addresses the issues that have historically limited access and quality. Homeward supports Medicare-eligible beneficiaries by partnering with health plans, providers, and communities to align incentives – taking full financial accountability for clinical outcomes and the total cost of care across rural counties. As a public benefit corporation and Certified B Corp™, Homeward’s mission and business model are aligned to address the healthcare, economic, and demographic challenges that make it challenging for rural Americans to stay healthy. Our Homeward Navigation™ platform uses advanced analytics to connect members to the right care and local resources that address social determinants of health and improve holistic health outcomes. Since many rural communities lack adequate clinical capacity, Homeward also employs care teams that supplement local practices and reach people who cannot otherwise access care. Homeward is co-founded by a leadership team that defined and delivered Livongo’s products, and backed most recently by a $50 million series B co-led by Arch Ventures and Human Capital, with participation from General Catalyst for a total of $70 million in funding. With this leadership team and funding, Homeward is committed to bringing high-quality healthcare to rural communities in need. The Opportunity: Join us in tackling healthcare for rural America. We’re seeking a Staff Medical Economics / Actuarial Analyst who is passionate about driving meaningful societal impact and using data to improve health equity for underserved communities. You’ll join our Medical Economics team and take end-to-end ownership of total cost of care performance across Medicare Advantage and/or Medicaid populations. In close partnership with Finance, Risk Adjustment, Clinical, and Market leaders, you will proactively identify cost drivers, forecast trends, and translate claims-based insights into strategic decisions that directly impact financial sustainability and patient outcomes. This is a high-impact, highly autonomous role for an experienced analyst who thrives in ambiguity, moves beyond reporting to actionable insight, and influences business strategy through rigorous analysis.

Requirements

  • 5+ years of experience in medical economics, actuarial analytics, or healthcare financial analytics.
  • Deep experience working with Medicare Advantage and/or Medicaid claims data.
  • Strong understanding of total cost of care drivers, healthcare utilization patterns, and PMPM financial analysis.
  • Experience forecasting medical cost trends and analyzing value-based contract performance.
  • Advanced Excel skills and strong SQL proficiency; experience working with large healthcare datasets.
  • Demonstrated ability to independently structure ambiguous problems and deliver insights that influence business decisions.
  • Strong communication skills with experience presenting findings to both technical and non-technical stakeholders.
  • Bachelor’s degree in actuarial science, mathematics, economics, statistics, or related field required.

Nice To Haves

  • Experience with CMS Risk Adjustment programs (HCC, RAF scoring).
  • Experience in value-based care organizations or at-risk provider groups.
  • Experience with Python or data visualization tools (Tableau, etc.).
  • Progress toward actuarial credentials (ASA/FSA).

Responsibilities

  • Lead end-to-end analysis of total cost of care across at-risk populations, identifying key drivers of medical expense across inpatient, outpatient, pharmacy, and professional services. Proactively surface financial risks and opportunities and recommend data-driven interventions.
  • Develop and maintain medical cost trend analyses and forecasts. Partner closely with Finance to align actuarial insights with P&L performance, budgeting, and contract strategy. Evaluate the performance of value-based contracts and quantify variance drivers.
  • Work deeply with medical and pharmacy claims data to analyze utilization patterns, PMPM trends, completion factors, and emerging experience. Apply working knowledge of Medicare Advantage and/or Medicaid program dynamics to interpret performance accurately.
  • Strengthen and scale reporting frameworks that monitor cost performance and contract outcomes. Improve methodologies for trending, benchmarking, and performance tracking to ensure rigor and reliability in financial insights.
  • Translate complex analyses into clear, actionable insights for senior leadership. Partner cross-functionally with Analytics, Data, Risk Adjustment, Contracting, and Operations to drive alignment and impact.
  • Support strategic initiatives including benchmarking, contract optimization, investor-facing analyses, and program performance evaluations as the organization scales.

Benefits

  • Competitive salary, equity grant, generous paid time off
  • Comprehensive benefits package including medical, dental & vision insurance with 100% of monthly premium covered for employees
  • Company-sponsored 401k plan
  • Flexible working arrangement
© 2024 Teal Labs, Inc
Privacy PolicyTerms of Service