Senior Director, Health Economics & Actuarial Analytics

Accountabilities: • Own the measurement strategy for clinical outcomes across member populations, including weight loss, A1c improvement, blood pressure control, food insecurity, HEDIS measures, and other quality metrics relevant to healthcare clients.

• Lead the development and ongoing refinement of ROI methodologies that translate clinical improvements into measurable economic value and identify the populations benefiting most from interventions.

• Serve as the senior technical representative when presenting and defending outcomes and ROI methodologies to payer actuarial teams, consultants, and other external stakeholders.

• Develop client-specific value analyses grounded in member outcomes, ensuring that economic impact is supported by rigorous methodology rather than generic benchmarks.

• Help shape value-based care strategy by evaluating target populations, expected outcomes, economic opportunity, and the level of performance that can be credibly guaranteed or committed to.

• Build scalable outcomes and ROI frameworks that can be consistently applied across new populations, clients, and payer engagements without requiring one-off analytical approaches.

• Partner with academic collaborators and internal scientific leadership on peer-reviewed research and evidence-generation initiatives.

• Work closely with clinical and care delivery teams to translate analytical findings into practical improvements in care delivery and member outcomes.

• Lead, mentor, and develop a small high-performing team while remaining directly involved in complex analytical and methodological work.

• Use AI-native tools and other advanced technologies to accelerate research, analysis, modeling, and problem-solving while maintaining rigorous human oversight and methodological standards.

Requirements:

• 10+ years of progressive experience in health economics, actuarial science, healthcare analytics, or a closely related quantitative discipline, with substantial experience applying analytical methods to healthcare cost and value questions.

• Proven experience demonstrating ROI and value to healthcare payers, ideally within a telehealth or digital health organization, or through prior payer or healthcare consulting experience followed by work in digital health.

• Deep hands-on experience working with healthcare claims data, including both medical and pharmacy claims, and using these datasets to analyze healthcare costs, utilization, outcomes, and trends.

• Strong expertise in causal inference and healthcare outcomes analysis, including matched cohort designs, risk adjustment, quasi-experimental methods, and other rigorous evaluation approaches.

• Demonstrated experience measuring clinical outcomes and healthcare quality across populations, with familiarity with HEDIS and common chronic-condition measures.

• Ability to develop, explain, and defend complex ROI and economic methodologies to payer actuaries, consultants, and other highly technical audiences.

• Experience with value-based care arrangements and a clear understanding of what healthcare providers or technology-enabled care organizations can credibly commit to.

• Strong systems-thinking skills and the ability to turn complex analytical work into repeatable, scalable methodologies rather than isolated analyses.

• Advanced degree or actuarial credentials such as ASA, FSA, or MAAA are advantageous but not required where equivalent practical expertise is demonstrated.

• Experience partnering with clinical, research, or care delivery teams to translate analytical findings into operational practice.

• Hands-on proficiency with data and analytical tools such as SQL, R, or Python.

• Familiarity with AI-native development and analytical tools, including Claude Code or comparable technologies, and a demonstrated ability to use AI as a productivity and analytical force multiplier.

• Peer-reviewed publication experience is a plus.

• Exceptional written and verbal communication skills, with the ability to communicate effectively with technical, executive, clinical, payer, and non-technical audiences.

• Strong leadership and mentoring capabilities, combined with a willingness to remain personally hands-on with high-impact analytical work.

Benefits:

• Base salary range of $210,000–$245,000 per year , plus bonus and benefits.

• Fully remote, remote-first working environment with location flexibility across the United States.

• Unlimited paid time off.

• Medical, dental, and vision healthcare coverage.

• 401(k) retirement benefits.

• Performance-based bonus opportunity.

• Access to Registered Dietitian sessions.

• Flexible working arrangements designed to support autonomy and work-life balance.

• Opportunity to lead a high-impact analytics function at the intersection of healthcare, digital health, actuarial science, and data science.

• Equal employment opportunities and an inclusive environment for qualified applicants.

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