Staff Medical Economics Analyst

AI overview

This high-impact role entails ownership of total cost of care performance for Medicare and Medicaid populations, requiring data-driven insights to enhance financial sustainability and patient care.

Homeward is rearchitecting the delivery of health and care in partnership with communities everywhere, starting in rural America. Today, 60 million Americans living in rural communities are facing a crisis of access to care. In the U.S. healthcare system, rural Americans experience significantly poorer clinical outcomes. This trend is rapidly accelerating as rural hospitals close and physician shortages increase, exacerbating health disparities. In fact, Americans living in rural communities suffer a mortality rate 23 percent higher than those in urban communities, in part because of the lack of access to quality care.

Our vision is care that enables everyone to achieve their best health. So, we’re creating a new healthcare delivery model that is purpose-built for rural America and directly addresses the issues that have historically limited access and quality. Homeward supports Medicare-eligible beneficiaries by partnering with health plans, providers, and communities to align incentives – taking full financial accountability for clinical outcomes and the total cost of care across rural counties.

As a public benefit corporation and Certified B Corp™, Homeward’s mission and business model are aligned to address the healthcare, economic, and demographic challenges that make it challenging for rural Americans to stay healthy. Our Homeward Navigation™ platform uses advanced analytics to connect members to the right care and local resources that address social determinants of health and improve holistic health outcomes. Since many rural communities lack adequate clinical capacity, Homeward also employs care teams that supplement local practices and reach people who cannot otherwise access care.

Homeward is co-founded by a leadership team that defined and delivered Livongo’s products, and backed most recently by a $50 million series B co-led by Arch Ventures and Human Capital, with participation from General Catalyst for a total of $70 million in funding. With this leadership team and funding, Homeward is committed to bringing high-quality healthcare to rural communities in need.

The Opportunity:

Join us in tackling healthcare for rural America. We’re seeking a Staff Medical Economics / Actuarial Analyst who is passionate about driving meaningful societal impact and using data to improve health equity for underserved communities.

You’ll join our Medical Economics team and take end-to-end ownership of total cost of care performance across Medicare Advantage and/or Medicaid populations. In close partnership with Finance, Risk Adjustment, Clinical, and Market leaders, you will proactively identify cost drivers, forecast trends, and translate claims-based insights into strategic decisions that directly impact financial sustainability and patient outcomes.

This is a high-impact, highly autonomous role for an experienced analyst who thrives in ambiguity, moves beyond reporting to actionable insight, and influences business strategy through rigorous analysis.

What You’ll Do:

Own Total Cost of Care Performance

  • Lead end-to-end analysis of total cost of care across at-risk populations, identifying key drivers of medical expense across inpatient, outpatient, pharmacy, and professional services. Proactively surface financial risks and opportunities and recommend data-driven interventions.

Financial Impact & Forecasting

  • Develop and maintain medical cost trend analyses and forecasts. Partner closely with Finance to align actuarial insights with P&L performance, budgeting, and contract strategy. Evaluate the performance of value-based contracts and quantify variance drivers.

Claims-Based & Program Expertise

  • Work deeply with medical and pharmacy claims data to analyze utilization patterns, PMPM trends, completion factors, and emerging experience. Apply working knowledge of Medicare Advantage and/or Medicaid program dynamics to interpret performance accurately.

Analytical Infrastructure & Methodology

  • Strengthen and scale reporting frameworks that monitor cost performance and contract outcomes. Improve methodologies for trending, benchmarking, and performance tracking to ensure rigor and reliability in financial insights.

Executive Communication & Cross-Functional Partnership

  • Translate complex analyses into clear, actionable insights for senior leadership. Partner cross-functionally with Analytics, Data, Risk Adjustment, Contracting, and Operations to drive alignment and impact.

Ad Hoc & Strategic Initiatives

  • Support strategic initiatives including benchmarking, contract optimization, investor-facing analyses, and program performance evaluations as the organization scales.

What You Bring:

List the qualifications and experience needed to succeed in the role.

  • 5+ years of experience in medical economics, actuarial analytics, or healthcare financial analytics.
  • Deep experience working with Medicare Advantage and/or Medicaid claims data.
  • Strong understanding of total cost of care drivers, healthcare utilization patterns, and PMPM financial analysis.
  • Experience forecasting medical cost trends and analyzing value-based contract performance.
  • Advanced Excel skills and strong SQL proficiency; experience working with large healthcare datasets.
  • Demonstrated ability to independently structure ambiguous problems and deliver insights that influence business decisions.
  • Strong communication skills with experience presenting findings to both technical and non-technical stakeholders.

Bonus Points If You Have:

  • Experience with CMS Risk Adjustment programs (HCC, RAF scoring).
  • Experience in value-based care organizations or at-risk provider groups.
  • Experience with Python or data visualization tools (Tableau, etc.).
    Progress toward actuarial credentials (ASA/FSA).
  • Bachelor’s degree in actuarial science, mathematics, economics, statistics, or related field required.

 

What Shapes Our Company:

  • Deep commitment to one another, the people and communities we serve, and to care that enables everyone to achieve their best health
  • Compassion and empathy
  • Curiosity and an eagerness to listen
  • Drive to deliver high-quality experiences, clinical care, and cost-effectiveness
  • Strong focus on the sustainability of our business and scalability of our services to maximize our reach and impact
  • Nurturing a diverse workforce with a wide range of backgrounds, experiences, and points of view
  • Taking our mission and business seriously but not taking ourselves too seriously– having fun as we build!

Benefits:

  • Competitive salary, equity grant, generous paid time off
  • Comprehensive benefits package including medical, dental & vision insurance with 100% of monthly premium covered for employees
  • Company-sponsored 401k plan
  • Flexible working arrangement

The base salary range for this position is $135,000 - $160,000. Compensation may vary outside of this range depending on a number of factors, including a candidate’s qualifications, skills, location, competencies and experience. Base pay is one part of the Total Package that is provided to compensate and recognize employees for their work at Homeward Health. This role is eligible for an annual bonus, stock options, as well as a comprehensive benefits package.

Inclusion & Belonging: 

At Homeward, a diverse set of backgrounds and experiences enrich our teams and allow us to achieve above and beyond our goals. If you have yet to gain experience in the areas detailed above, we hope you will share your unique background with us in your application and how it can be additive to our teams.

Homeward is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. Homeward is committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities.

Perks & Benefits Extracted with AI

  • Equity Compensation: equity grant
  • Health Insurance: Comprehensive benefits package including medical, dental & vision insurance with 100% of monthly premium covered for employees
  • Home Office Stipend: Flexible working arrangement
  • 401k plan: Company-sponsored 401k plan
  • Paid Time Off: generous paid time off
Salary
$135,000 – $160,000 per year
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