Stellar Health
Overview
Senior Director, Medical Economics at Stellar Health. Join to apply for the Senior Director, Medical Economics role at Stellar Health. About Stellar Health: Historically, US healthcare has relied on a fee-for-service reimbursement system where providers are paid based on the quantity of patient visits and procedures, rather than the quality of health outcomes. At Stellar Health, we help primary care providers put patient health first. Our platform — a mix of technology, people, and analytics — supports providers at the point of care, delivering real-time patient information, activating practice staff, and empowering providers and care teams with incentives that reward the work they are already doing to keep patients healthy. Using the Stellar App, practices receive a simple checklist of recommended actions that support the best quality care. Providers and care teams are then paid monthly for each action they complete, and payors save money in reduced healthcare costs along the way. Stellar is a US-based health-tech company backed by top VCs with an established product and proven operating model. About the position : The Senior Director of Medical Economics will help drive overall surplus performance in Stellar’s ACO and Payor Risk Contracts by utilizing standardized medical economics tools and analyses to determine performance needs in major functional areas, drilling down to understand provider/region-specific opportunities and trends, and communicating with key stakeholders to support their generation of performance management strategies and measurement of impact. This role is critical to creating the underlying business intelligence, performance measurement and target setting for Stellar Health’s ACO and all total cost of care risk contracts. This hire will serve as the leader of this functional Medical Economics Organization, building and managing a team of Actuaries and Medical Economic Analysts, reporting directly into the VBC Organizational Leader who owns performance for all total cost of care risk contracts. What you’ll do
Individually contribute and Manage core Medical Economics Analyses and Outputs Medical Economics Identify and report on cost and utilization trends Develop standardized views and complete ad hoc analyses to identify high-cost patients, disease states, or provider-level views Lead Stellar cross-functional Medical Economics committee meetings with Product and Tech to review findings and discuss intervention opportunities Create standardized Revenue & Cost of Care reporting for Medical Groups, including development and identification of a standard set of "key opportunities" for medical groups Conduct Impact Assessments: analyze clinical interventions to evaluate their impact on patient utilization and cost of care; develop methodologies to isolate effects of interventions; advise on study design for robust impact assessments Collaborate with Stellar's Enterprise Analytics to build new enterprise data tools, techniques and standards Attribution & Risk Adjustment Accuracy Analytics Within the ACO, use claims data to identify attributable patients and patients at risk of losing attribution Work with performance management teams to identify strategies to maintain/grow membership Create ACO and Medical Group-level reporting showing attribution opportunities and risks Create and model impact of risk adjustment accuracy efforts; assist with setting targets where relevant Identify areas of potential risk adjustment inaccuracy for Performance & Operations teams Manage and Direct Core Actuarial Analyses and Forecasting VBC Contracting and Growth Using Stellar data and CMS data to identify Medical groups as targets for growth within our ACO or other total cost of care risk contracts Support negotiations with health plans and provider partners by identifying levers of Stellar performance within contracts and creating models to show range of opportunity or risk Quantify and manage financial risk using mathematical and financial theories Forecasting and Risk Management Create regular financial forecasting for surplus performance for each contract and portfolio views Identify key cost trends and any potential fraud/waste for deeper medical economic investigation Support evaluation/analysis of financial reserving and reinsurance Qualifications 10+ years in a Medical Economics role with internal stakeholders to answer business questions Actuarial designation preferred, but not required Experience analyzing and summarizing medical claims data (utilization and cost) Experience with Value-based contracting design Deep understanding of medical economic cost modeling, reporting/trending, and opportunity identification Risk adjustment (MA/MSSP) knowledge Strong working knowledge of scripting or data mining tools like R, Python and SQL Proficiency with BI tools (Tableau, Looker, PowerBI, SAP/Business Objects, SAS, etc.) for data analysis and visualization Experience in a cloud-based data warehouse environment (e.g., Snowflake or Databricks) Able to turn Excel and SQL analyses into usable presentations and memos for cross-team communication Track record of driving performance in value-based risk contracts Value-based performance strategy and contracting experience Experience/understanding of quality and risk adjustment programs Strong analytic skills with ability to make informed business recommendations from statistical inferences Exceptional communicator who can crisply articulate problems and solutions under uncertainty Who will love this job Analytical problem-solvers who can structure unstructured problems and work with messy data Interested in value-based care and healthcare technology startups Autonomy, with the ability to voice opinions to improve processes Passionate about empowering value-based care in primary care Focus on care delivery and patient outcomes Experience building infrastructure in a fast-paced environment Compensation : The salary range for this role is $200,000 - $240,000 plus an annual performance-based bonus. Compensation placement depends on skills and experience. Stellar allows for growth within the role. Perks & Benefits Medical, Dental and Vision Benefits Flexible PTO Universal Paid Family Leave Company-sponsored memberships (One Medical, Citibike) Medical Travel Benefits Monthly wellness stipend Stock Options & 401k matching Career development opportunities and internal mobility Company-sponsored social events Diversity & Privacy Stellar Health is an equal opportunity employer and complies with applicable laws. We are committed to an inclusive environment and protecting candidate privacy. Stellar Health Employment Privacy Notice: At Stellar Health, your privacy and security as a job seeker is a priority. If you have questions about legitimacy, use an @stellar.health email address for communication and report phishing to authorities as advised in the description. Seniority level: Director Employment type: Full-time Job function: Health Care Provider
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Senior Director, Medical Economics at Stellar Health. Join to apply for the Senior Director, Medical Economics role at Stellar Health. About Stellar Health: Historically, US healthcare has relied on a fee-for-service reimbursement system where providers are paid based on the quantity of patient visits and procedures, rather than the quality of health outcomes. At Stellar Health, we help primary care providers put patient health first. Our platform — a mix of technology, people, and analytics — supports providers at the point of care, delivering real-time patient information, activating practice staff, and empowering providers and care teams with incentives that reward the work they are already doing to keep patients healthy. Using the Stellar App, practices receive a simple checklist of recommended actions that support the best quality care. Providers and care teams are then paid monthly for each action they complete, and payors save money in reduced healthcare costs along the way. Stellar is a US-based health-tech company backed by top VCs with an established product and proven operating model. About the position : The Senior Director of Medical Economics will help drive overall surplus performance in Stellar’s ACO and Payor Risk Contracts by utilizing standardized medical economics tools and analyses to determine performance needs in major functional areas, drilling down to understand provider/region-specific opportunities and trends, and communicating with key stakeholders to support their generation of performance management strategies and measurement of impact. This role is critical to creating the underlying business intelligence, performance measurement and target setting for Stellar Health’s ACO and all total cost of care risk contracts. This hire will serve as the leader of this functional Medical Economics Organization, building and managing a team of Actuaries and Medical Economic Analysts, reporting directly into the VBC Organizational Leader who owns performance for all total cost of care risk contracts. What you’ll do
Individually contribute and Manage core Medical Economics Analyses and Outputs Medical Economics Identify and report on cost and utilization trends Develop standardized views and complete ad hoc analyses to identify high-cost patients, disease states, or provider-level views Lead Stellar cross-functional Medical Economics committee meetings with Product and Tech to review findings and discuss intervention opportunities Create standardized Revenue & Cost of Care reporting for Medical Groups, including development and identification of a standard set of "key opportunities" for medical groups Conduct Impact Assessments: analyze clinical interventions to evaluate their impact on patient utilization and cost of care; develop methodologies to isolate effects of interventions; advise on study design for robust impact assessments Collaborate with Stellar's Enterprise Analytics to build new enterprise data tools, techniques and standards Attribution & Risk Adjustment Accuracy Analytics Within the ACO, use claims data to identify attributable patients and patients at risk of losing attribution Work with performance management teams to identify strategies to maintain/grow membership Create ACO and Medical Group-level reporting showing attribution opportunities and risks Create and model impact of risk adjustment accuracy efforts; assist with setting targets where relevant Identify areas of potential risk adjustment inaccuracy for Performance & Operations teams Manage and Direct Core Actuarial Analyses and Forecasting VBC Contracting and Growth Using Stellar data and CMS data to identify Medical groups as targets for growth within our ACO or other total cost of care risk contracts Support negotiations with health plans and provider partners by identifying levers of Stellar performance within contracts and creating models to show range of opportunity or risk Quantify and manage financial risk using mathematical and financial theories Forecasting and Risk Management Create regular financial forecasting for surplus performance for each contract and portfolio views Identify key cost trends and any potential fraud/waste for deeper medical economic investigation Support evaluation/analysis of financial reserving and reinsurance Qualifications 10+ years in a Medical Economics role with internal stakeholders to answer business questions Actuarial designation preferred, but not required Experience analyzing and summarizing medical claims data (utilization and cost) Experience with Value-based contracting design Deep understanding of medical economic cost modeling, reporting/trending, and opportunity identification Risk adjustment (MA/MSSP) knowledge Strong working knowledge of scripting or data mining tools like R, Python and SQL Proficiency with BI tools (Tableau, Looker, PowerBI, SAP/Business Objects, SAS, etc.) for data analysis and visualization Experience in a cloud-based data warehouse environment (e.g., Snowflake or Databricks) Able to turn Excel and SQL analyses into usable presentations and memos for cross-team communication Track record of driving performance in value-based risk contracts Value-based performance strategy and contracting experience Experience/understanding of quality and risk adjustment programs Strong analytic skills with ability to make informed business recommendations from statistical inferences Exceptional communicator who can crisply articulate problems and solutions under uncertainty Who will love this job Analytical problem-solvers who can structure unstructured problems and work with messy data Interested in value-based care and healthcare technology startups Autonomy, with the ability to voice opinions to improve processes Passionate about empowering value-based care in primary care Focus on care delivery and patient outcomes Experience building infrastructure in a fast-paced environment Compensation : The salary range for this role is $200,000 - $240,000 plus an annual performance-based bonus. Compensation placement depends on skills and experience. Stellar allows for growth within the role. Perks & Benefits Medical, Dental and Vision Benefits Flexible PTO Universal Paid Family Leave Company-sponsored memberships (One Medical, Citibike) Medical Travel Benefits Monthly wellness stipend Stock Options & 401k matching Career development opportunities and internal mobility Company-sponsored social events Diversity & Privacy Stellar Health is an equal opportunity employer and complies with applicable laws. We are committed to an inclusive environment and protecting candidate privacy. Stellar Health Employment Privacy Notice: At Stellar Health, your privacy and security as a job seeker is a priority. If you have questions about legitimacy, use an @stellar.health email address for communication and report phishing to authorities as advised in the description. Seniority level: Director Employment type: Full-time Job function: Health Care Provider
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