The Opportunity:

As we continue to expand our capacity to provide human-centered, tech-forward care to patients across generations, the teams that support that work are growing as well! One Medical is seeking a highly skilled Sr. Manager of Medical Economics to join our Medicare Population Health Programs (MPHP) team to lead the team’s overall Value-based Care data, analytics and evaluation strategy.

Reporting to Chief Medicare Performance Officer, you will play a pivotal role in driving strategic initiatives focused on improving clinical outcomes, total cost of care and financial performance for our nationally scaled, global risk Medicare Advantage and ACO Reach business. Working within a highly matrixed environment alongside analytics, data engineering and financial actuarial teams, you will leverage your expertise to analyze healthcare data, identify trends, and develop actionable insights. You will also work closely with other leaders of the MPHP team to embed data in clinical and operational workflows and enable the ongoing monitoring and continuous improvement of high impact programs.

If you are passionate about transforming healthcare delivery through data-driven insights and value-based care, we invite you to join our team of dedicated professionals. Together, we will shape the future of population health management and make a positive impact on the lives of patients and communities. Apply today to be part of our mission-driven organization.

What you will work on:

Data Analysis and Interpretation:

• Utilize advanced analytical techniques to analyze healthcare data sets, including claims data, clinical data, and population health metrics.
• Identify patterns, trends, and opportunities for improving patient outcomes, cost-efficiency, and quality of care.
• Develop predictive models to forecast healthcare utilization, cost trends, and population health risks.

Value-Based Care Data Strategy:

• Prioritize MPHP analytic needs across lanes and manage collaborative roadmap development with the VBC data, analytics and actuary teams.
• Identify best in class tools, datasets, analytic logic (e.g. groupers, industry standard metrics) to enable generation of insights from raw data
• Consult with MPHP program leaders on the use and generation of data to support MPHP program operations, management and impact analyses.
• Work with external data vendors to improve the availability and synthesis of clinical and financial data relevant to VBC outcomes
• Provide insights and recommendations to enhance care delivery models, care coordination efforts, and population health management initiatives.
• Evaluate the effectiveness of value-based care programs through robust performance metrics and KPIs.

Program Analysis and Reporting:

• Conduct financial analyses to assess the impact of value-based care initiatives on revenue, costs, and overall financial performance.
• Generate comprehensive reports and presentations to communicate findings, trends, and recommendations to key stakeholders, including senior leadership, clinical teams, and payer partners.

Risk Adjustment and Actuarial Support:

• Collaborate with the Medicare Risk Operations and actuarial teams and to support risk adjustment methodologies, including HCC coding, RAF scores, and risk stratification models.
• Monitor and analyze actuarial data to ensure alignment with population health objectives and regulatory requirements.

Continuous Improvement and Innovation:

• Stay abreast of emerging trends, regulations, and technologies in healthcare analytics, population health management, and value-based care.
• Identify opportunities for process improvements, data optimization, and innovation within the Population Health Team and across the organization.
• Actively participate in research, industry conferences, and knowledge sharing activities to foster a culture of learning and excellence.

What you’ll need:

• 8+ years of experience in healthcare analytics, medical economics, or population health management within a provider organization, payer, or healthcare consulting firm.
• Strong proficiency in data analysis tools and programming languages (e.g., SQL, Python, R) for healthcare analytics.
• In-depth knowledge of value-based care models, healthcare reimbursement methodologies, and regulatory requirements (e.g., MACRA, MIPS, ACOs).
• Experience working with actuarial teams and familiarity with risk adjustment methodologies (e.g., HCC coding).
• Excellent communication skills with the ability to translate complex data insights into actionable recommendations for diverse stakeholders.
• Proven track record of driving results, influencing decision-making, and fostering collaboration in a matrixed organizational structure.
• Prefer Master's degree in Economics, Statistics, or related field.

Benefits designed to aid your health and wellness:

Taking care of you today

• Employee Assistance Program - Free confidential advice for team members who need help with stress, anxiety, financial planning, and legal issues
• Competitive Medical, Dental and Vision plans
• Free One Medical memberships for yourself, your friends and family
• Pre-Tax commuter benefits
• PTO cash outs - Option to cash out up to 40 accrued hours per year

Protecting your future for you and your family

• 401K match
• Opportunity to participate in company equity programs
• Credit towards emergency childcare
• Company paid maternity and paternity leave
• Paid Life Insurance - One Medical pays 100% of the cost of Basic Life Insurance
• Disability insurance - One Medical pays 100% of the cost of Short Term and Long Term Disability Insurance

This is a full-time role based in anywhere in the US remote

One Medical is committed to fair and equitable compensation practices. The base salary range for this role is $123,000 to $219,000 per year. However, actual compensation packages are based on several factors that are unique to each candidate. These factors include, but are not limited to, job related knowledge and skill set, depth of experience, certifications and/or degrees, and specific work location. The total compensation package for certain roles may also include additional components such as a sign-on bonus, equity grants in the form of RSUs, medical and other benefits and/or other applicable incentive compensation plans. For more information, please visit https://www.onemedical.com/careers/.

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