Director of Medical Economics and Actuarial Services

At Devoted Health, we are on a mission to transform the health and well-being of older Americans by prioritizing compassionate care. We are building an innovative healthcare company that merges health insurance, clinical care, service, and technology into a cohesive and supportive solution. Our rapid growth since our founding in 2017 allows us to serve members across the United States, and we are just getting started. Join us in this meaningful mission! About the Position The Director of Medical Economics will be instrumental in leading enterprise-wide initiatives focused on cost improvement within our organization. This role requires collaboration with various segments of our business, including market leadership, claims, network, and the actuarial team. We seek a dynamic leader with a solid foundation in healthcare economics, data-driven decision-making, and strategic planning to navigate and enhance our healthcare delivery systems and reimbursement strategies. Key Responsibilities: Lead cross-functional initiatives aimed at enhancing medical costs and quality of care, including provider reimbursement strategies, utilization management, and value-based payment models. Analyze healthcare utilization trends, cost factors, and performance metrics to uncover potential improvements and cost savings. Work collaboratively with teams across clinical leadership, actuarial, finance, and operations to develop and execute strategies that align with company goals. Employ analytical methods with finance and data science teams to project and assess the financial impact of strategic initiatives. Oversee the success of implemented initiatives through ongoing performance evaluation and provide actionable recommendations for improvement. Stay informed about industry trends, regulations, and best practices in healthcare economics and medical cost management to enhance strategic planning. Act as a subject matter expert on medical economics, offering guidance to both internal stakeholders and external partners. Prepare and deliver regular reports and presentations to senior leadership regarding the progress of cost improvement initiatives and financial outcomes. Required Qualifications: Over 10 years of experience in Medicare Advantage, particularly in medical expenses and economics. Integrity and the ability to maintain confidentiality regarding sensitive information at all times. Strong analytical skills and a proactive approach to leadership and team contribution from day one. Exceptional communication and interpersonal abilities, with experience engaging various stakeholders. Comprehensive understanding of financial drivers in Medicare Advantage operations. In-depth knowledge of healthcare delivery systems, payment structures, and regulations relevant to managed care and insurance. Strategic vision to connect financial relationships across the organization. Capacity to thrive in a fast-paced, evolving start-up environment. Skill to present opportunities for growth across all organizational sectors including clinical, operations, and finance. Desired Qualifications: Actuarial credential (ASA or FSA) is advantageous but not mandatory. Solid grounding in managed care principles including underwriting, risk adjustment, medical management, and financial risk management. Experience in extracting and analyzing healthcare claims data; proficiency in SQL, R, or Python is a plus. Salary and Benefits: Salary will be commensurate with experience, and our total rewards package includes: Employer-sponsored health, dental, and vision insurance with minimal to no premium. Generous paid time off. $100 monthly stipend for mobile or internet use. Stock options for all employees. Bonus eligibility for non-director roles; commission for sales roles. Parental leave program. 401(k) program. And more... Our total rewards package applies to full-time employees, while intern and contract positions are excluded. Devoted Health is committed to healthcare equality, treating our members like family. We uphold a diverse and inclusive workforce and adhere to a strict equal opportunity policy. We value the unique perspectives and skills of each individual, ensuring a respectful and collaborative workplace.