Senior Director of Medical Economics

Job Summary

This role is a senior leader responsible for advancing Absolute Care’s financial performance, value-based care strategy, and population health objectives through healthcare economics, strategic analytics, and executive decision support. The role serves as the primary Medical Economics partner and trusted advisor to Market Presidents and Executive Leadership, translating complex healthcare, financial, operational, clinical, membership, and payer data into actionable insights.

This Senior Director leads the Market Performance function, including total cost of care analytics, forecasting, shared-savings and risk-contract analytics, payer reconciliations, and executive decision support. This role serves as the organizational subject matter expert for the application of risk-adjustment and acuity methodologies within Medical Economics, including how population risk is measured and applied in forecasting, financial modeling, market-performance evaluation, and value-based contract analytics.

• Serve as a trusted advisor to Market Presidents and Executive Leadership.
• Lead market-level financial performance, total cost of care, utilization, revenue, quality, membership, and payer-performance evaluations.
• Lead market performance reviews that clarify results, outlook, risks, opportunities, and decisions required.
• Develop executive narratives and recommendations connecting financial results with clinical, operational, membership, contractual, and population-risk drivers.

• Lead forecasting, trend and seasonality analysis, claims completion methodologies, IBNR estimates, membership projections, and financial performance forecasts.
• Oversee analytics supporting shared savings, downside risk, risk-sharing arrangements, and other value-based payment models.
• Lead reconciliations involving claims, membership, eligibility, attribution, revenue, capitation, risk adjustment, and payer-reported performance.
• Serve as the organizational subject matter expert for the application of risk-adjustment and acuity methodologies within Medical Economics. Establish and maintain analytical approaches used to assess population risk, forecast performance, evaluate market acuity, and support value-based contract analytics.
• Partner with Quality and Risk Reporting leaders to maintain consistency between financial methodologies, quality-performance measurement, risk-adjustment reporting, population health analytics, and risk-recapture program reporting.
• Evaluate payer-reported results against contract provisions, underlying data, and established analytical methodologies.

• Partner with Market Presidents, Clinical Leadership, Operations, Finance, and Payer Operations to identify opportunities to improve outcomes, affordability, and financial performance.
• Analyze drivers across markets, populations, services, providers, and payer arrangements.
• Measure the impact of interventions and support ROI and investment decisions.

• Advance forecasting, predictive analytics, automation, and appropriately governed AI-enabled decision support.
• Partner with Data Engineering, Information Technology, Finance, Payer Operations, and operational stakeholders to improve data quality and develop scalable analytical solutions.
• Establish consistent definitions, methodologies, documentation, peer review, quality controls, and governance processes.
• Reduce reliance on manual, duplicative, and person-dependent processes.

• Recruit, lead, mentor, and retain a high-performing team of Medical Economics professionals.
• Develop senior analysts and managers to lead work…