Sr. Director/VP - Medical Economics

Department: Medical Economics

Location: 1668 S. Garfield Ave. 2nd Floor, Alhambra, CA 91801

Description

Astrana Health is seeking a Sr. Director of Medical Economics to lead advanced medical cost analytics and drive strategic insights across our risk-based business. This leader will help identify cost drivers, evaluate financial performance, and partner with clinical, operational, and finance leaders to improve performance across health plan contracts and provider networks.

This role requires a hands-on leader who can translate complex healthcare data into actionable insights and influence decisions across the organization.

What You'll Do

• Lead medical cost and utilization analysis across Medicare Advantage, Managed Medicaid, and Commercial populations
• Identify key drivers of medical expense trends and develop actionable recommendations to improve performance
• Partner with clinical and operational leaders to improve utilization and reduce avoidable costs
• Monitor and analyze specialty cost trends and capitation performance, identifying cost drivers and partnering with clinical and operational leaders to improve performance across risk-based contracts
• Support financial forecasting and performance tracking for risk-based and capitated contracts
• Develop and monitor key performance metrics including cost trends, utilization, and margin performance
• Lead analyses to support payer contracting, rate negotiations, and network performance evaluation
• Oversee development of dashboards and reporting to support executive decision-making
• Present insights and recommendations to senior leadership
• Partner cross-functionally with Finance, Network Management, Clinical Operations, and Data & Analytics teams
  
  

Qualifications

• 14 years of experience in medical economics, healthcare analytics, actuarial analysis, or healthcare finance
• Strong experience working with risk-based or capitated healthcare models
• Deep understanding of medical cost drivers, utilization metrics, and healthcare financial performance
• Experience analyzing claims data and population health performance
• Demonstrated experience leading analytics or medical economics teams
• Strong business judgment and ability to translate data into strategic insights
• Experience working cross-functionally with clinical, operational, and finance teams
• Advanced Excel and data analysis skills required
• Advanced experience with SQL or BI tools required
• Excellent communication skills with experience presenting to executive leadership
  
  

Environmental Job Requirements and Working Conditions

• This position is remotely based in the U.S. However, strong preference for candidates who can work hybrid in Los Angeles, Las Vegas, or Houston.
• The total compensation target pay range for this role is: $180,000 - $230,000. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
  

Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided based on qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.

Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.