Senior Medical Economics Analyst

Senior Medical Economics 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 Medical Economics 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. Success Measures: In 3 months: Gain full command of data and methodologies. 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. 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: Support pricing validation, reconciliation modeling, and performance evaluation analyses 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 Develop and operationalize predictive models for cost, utilization, quality outcomes, and performance evaluation 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 Position Requirements: Bachelor's degree in a STEM field, with Master’s degree preferred, 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 Strong proficiency in SQL, Tableau, and Excel Experience utilizing Python or R is a plus Position 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 HSAs UNLIMITED time off Matching 401(k) plan Mac laptop and accessories Company-paid short-term and long-term disability Company-paid life insurance Employee Assistance Program Annual professional development stipend All employees are required to maintain confidentiality as related to patient…