Senior Health Care Economics & Value-Based Analyst

Senior Health Care Economics & Value-Based AnalystEnlace 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.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 programsConstruct prospective and retrospective target-setting methodologies using difference-in-differences approaches, market benchmarking, credibility weighting, and risk-adjusted baselinesEvaluate financial and quality performance across Commercial, Medicare Advantage, and Medicaid lines of businessSupport pricing validation, reconciliation modeling, and performance evaluation analysesDevelop 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 modelingBuild provider performance classifiers and volume-based credibility frameworksConduct contracted vs. non-contracted provider performance comparisonsSupport steerage, network optimization, and care management analyticsPerform medical cost trend decomposition (unit cost vs. utilization vs. intensity vs. mix)Conduct risk-adjusted PMPM analysis across specialties, site-of-service, and population segmentsAnalyze longitudinal performance across defined assessment periodsQuantify impact of specialty utilization patterns and referral dynamicsEvaluating acuity, case-mix, and coding impacts across populationsWrite advanced SQL queries to construct episode-level, provider-level, and member-monthdatasetsDevelop repeatable analytic workflows supporting production modelingBuild executive-facing dashboards in TableauConstruct Excel-based financial models for pricing and reconciliation analysesPosition 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 experience5+ years of experience working within a payer or provider organization, or with healthcare analytics or care management organizationsDemonstrated experience across Commercial, Medicare (including MA), and Medicaid populationsDeep experience working the following types of data:Medical claims dataEnrollment and eligibility dataProvider dataCMS revenue and risk adjustment dataValue-based performance datasetsFamiliarity with EMR/EHR and SDOHStrong proficiency in SQL, Tableau, and ExcelExperience utilizing Python or R is a plusPosition Perks:Enlace Health offers competitive benefits and perks to all our employees! Our comprehensive benefits package is one of the many ways we show our employees how valued they are. All full-time employees are eligible for the following:FREE medical, dental, and vision insurance for employees on select plans$1740 annual contribution into qualifying HSAsUNLIMITED time offMatching 401(k) planMac laptop and accessoriesCompany-paid short-term and long-term disabilityCompany-paid life insuranceEmployee Assistance ProgramAnnual professional development stipendAll employees are required to maintain confidentiality as related to patient information. Employees are required to follow the acceptable use policy while using any information systems owned or controlled by Enlace. Any disclosures of confidential information made unlawfully outside the proper course of duty will be treated as a serious disciplinary offense. Security roles and responsibilities include:Implementing and acting in accordance with the organization's information security policiesProtecting assets from unauthorized access, disclosure, modification, destruction, or interferenceExecuting particular security processes or activitiesEnsuring responsibility is assigned to the individual for actions takenReporting security events or potential events or other security risks to the organization