Senior Medical Economics Analyst

About the Company

Enlace Health is a specialty value-based care company focused on reducing the cost of care where it matters most: specialty services. Operating across 80+ markets, Enlace delivers actionable intelligence to help payors lower medical loss ratios and drive sustainable financial performance.

Responsibilities

• Support pricing validation, reconciliation modeling, and performance evaluation analyses
• Construct prospective and retrospective target-setting methodologies using difference-in-differences and risk-adjusted baselines
• Evaluate financial and quality performance across Commercial, Medicare Advantage, and Medicaid lines of business
• Develop and operationalize predictive models for cost, utilization, and quality outcomes
• Perform medical cost trend decomposition and risk-adjusted PMPM analysis
• Write advanced SQL queries to construct episode-level, provider-level, and member-month datasets
• Quantify impact of specialty utilization patterns and referral dynamics

Requirements

• Bachelor's degree in a STEM field (Master's preferred)
• 5+ years of experience in a payer or provider organization or healthcare analytics
• Demonstrated experience with Commercial, Medicare (including MA), and Medicaid populations
• Deep experience with medical claims, enrollment, provider, and CMS risk adjustment data
• Strong proficiency in SQL, Tableau, and Excel

Preferred Qualifications

• Experience utilizing Python or R