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Principal, Medical Economics

Role overview

Qualifications

  • Bachelor’s degree in economics, statistics, mathematics, public health, healthcare administration, data science, or a related field; an advanced degree is preferred.
  • 8+ years of experience in healthcare analytics, medical economics, actuarial analytics, or a related analytical function within the healthcare industry, with a focus on medical cost, utilization, or financial performance metrics. Experience with causal inference is preferred.
  • Deep understanding of healthcare claims data structures, medical coding systems, and reimbursement concepts, including ICD-10-CM, CPT, HCPCS, DRGs, capitation, fee-for-service, and value-based payment models.
  • Strong SQL skills are required; experience with Python, R, or other analytical tools is preferred.

Responsibilities

  • Lead and define statistical analyses to identify cost, utilization, and performance drivers across populations, markets, and payer arrangements.
  • Partner with data, actuarial, and analytics teams to validate healthcare claims data structures, ensure data is accurately represented in enterprise datasets, and resolve discrepancies affecting downstream reporting and analysis.
  • Apply economic insights to strengthen impact modeling and quantify the financial and operational implications of clinical and business initiatives.
  • Translate complex claims, reimbursement, and utilization data into clear, actionable recommendations for cross-functional stakeholders and senior leadership.

About the company

Evergreen Nephrology logo

Evergreen Nephrology

Medical Practices & Clinics

The current healthcare system is broken. We are here to change that. At Evergreen we believe every person deserves a better healthcare experience. We partner with nephrologists to provide comprehensive care that goes beyond kidney disease and addresses the patient as a whole including the emotional, spiritual, mental, and social aspects of their lives. We believe that by focusing on our patients' complete care needs through a value-based care model we can change the trajectory of healthcare. Join us.

Company details

Company typeSME
IndustryMedical Practices & Clinics
Company size201 - 500

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Job description

Who We Are 

Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic, and comprehensive approach to kidney care. We believe patients living with kidney disease deserve the best care. We are committed to improving patient outcomes and improving quality of life by delaying disease progression, shifting care to the home, and accelerating kidney transplants. 

We help nephrologists focus on the right patients at the right time across the full care spectrum. We do this by providing them with the best-in-class interdisciplinary clinical resources, analytical insight and tools, and services to patients. We listen to the needs of our patients, our employees, and our client partners, continually working to push beyond the status quo in which the care system manages patients today. 

Who You Are 

You are devoted, compassionate, and enjoy being on the front lines of healthcare, changing the lives of patients by supporting them and the team by focusing on customers. You’re excited about being part of a team that is building a healthcare delivery model that ensures the highest possible quality of life and best outcomes for those in our care. You believe people living with kidney disease deserve the best person-centered, holistic, comprehensive care and want to influence the healthcare system to drive towards that. You thrive in innovative and evolving environments with high rates of change.  

Your Role 

As a Principal, Medical Economics at Evergreen Nephrology, you will play a key role, as an individual contributor, in shaping and advancing the organization’s medical economics capabilities. You will partner closely with leaders across Analytics, Actuarial, Clinical, Operations, Finance, and Technology to strengthen our analytical capabilities. This role will help ensure the integrity of claims data flowing into enterprise datasets, enable more sophisticated economic and impact modeling, and connect cost insights with clinical and risk stratification efforts to support value-based care performance. 

Role Responsibilities 

  • Lead and define statistical analyses to identify cost, utilization, and performance drivers across populations, markets, and payer arrangements. 
  • Partner with data, actuarial, and analytics teams to validate healthcare claims data structures, ensure data is accurately represented in enterprise datasets, and resolve discrepancies affecting downstream reporting and analysis. 
  • Apply economic insights to strengthen impact modeling and quantify the financial and operational implications of clinical and business initiatives. 
  • Develop experimental designs for new program initiatives to ensure programs are set up for impact analysis in advance 
  • Translate complex claims, reimbursement, and utilization data into clear, actionable recommendations for cross-functional stakeholders and senior leadership. 
  • Identify trends, anomalies, and emerging opportunities within claims and performance data, and communicate their implications for value-based care strategy. 

Required Qualifications 

  • Bachelor’s degree in economics, statistics, mathematics, public health, healthcare administration, data science, or a related field; an advanced degree is preferred. 
  • 8+ years of experience in healthcare analytics, medical economics, actuarial analytics, or a related analytical function within the healthcare industry, with a focus on medical cost, utilization, or financial performance metrics. Experience with causal inference is preferred. 
  • Deep understanding of healthcare claims data structures, medical coding systems, and reimbursement concepts, including ICD-10-CM, CPT, HCPCS, DRGs, capitation, fee-for-service, and value-based payment models. 
  • Demonstrated ability to assess data quality, investigate discrepancies, and partner with technical teams to improve data integrity and usability. 
  • Strong SQL skills are required; experience with Python, R, or other analytical tools is preferred. 
  • Strong problem-solving, critical thinking, project management, and cross-functional collaboration skills, with the ability to influence stakeholders at multiple levels of the organization. 
  • Able to work effectively in a primarily remote environment: 
    • Home internet must support a minimum download speed of 25 Mbps and upload speed of 10 Mbps. Cable, Fiber, or DSL connections hardwired to the internet device are recommended 
    • Evergreen will provide remote employees with telephony applications and equipment to meet the business requirements for their role 
    • Employees must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information 

Compensation 

The pay range for this role is $135,000 to $150,000 annually. Exact pay is determined based on experience, education, demand for the role, and other role-specific factors.   

This role is also eligible for an annual bonus.  

Benefits  

Evergreen Nephrology’s total rewards program is designed to support you in and outside of work. You can expect: 

  • Paid time off starting at 4 weeks for full-time employees 
  • 12 paid holidays per year 
  • Medical, dental, vision and life insurance, including an HSA with employer match 
  • Reimbursement for continuing medical education for eligible roles 
  • A 401(k) program where Evergreen matches up to 4% of contributions after six months of tenure
  • Paid parental leave 
  • A robust training and development program that starts with onboarding and continues throughout your career with Evergreen Nephrology 

 

Evergreen Nephrology is an equal opportunity employer. Applicants will not be discriminated against because of race, color, creed, sex, sexual orientation, gender identity or expression, age, religion, national origin, citizenship status, disability, ancestry, marital status, veteran status, medical condition or any other protected category under local, state or federal laws. 

 

If you are an applicant with a disability who requires reasonable accommodation for any part of the hiring process, please contact us for assistance at recruiting@evergreennephrology.com 

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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