Director of Healthcare Economics

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🕒 May 1

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ProgenyHealth, LLC

WebsiteLinkedInAll Job Openings

201 - 500 employees

⚕️ Healthcare Insurance

☁️ SaaS

🧘 Wellness

Healthcare Insurance • SaaS • Wellness

ProgenyHealth, LLC is a company focused on transforming healthcare for women, infants, and families through its integrated Maternity and NICU Care Management solutions. With over 20 years of experience, ProgenyHealth provides a comprehensive care management solution to address the maternity and NICU challenges faced by modern health plans. By identifying risks early, the company aims to prevent preterm births, NICU stays, and complications during pregnancy and after delivery. ProgenyHealth operates as a trusted partner for health plans, overseeing a full maternal and infant care continuum, creating lasting relationships, and optimizing maternal and infant healthcare economics. The company also helps solve non-clinical social drivers impacting maternal and infant health, ensuring equitable, standardized, and predictable family care.

📋 Description

• Analyze claims and EMR data to quantify the clinical and financial impact of ProgenyHealth programs, including cost, utilization, and outcomes • Develop and communicate clear, credible ROI narratives for clients and prospective clients • Partner with clinical, client success, and growth teams to identify where the program is succeeding and where improvement is needed • Translate ambiguous business questions into structured analyses and actionable insights • Build and standardize analytical approaches, reporting, and data processes from the ground up • Serve as a subject matter expert on healthcare cost drivers, reimbursement methodologies, and Medicaid populations • Present findings to internal leadership and external stakeholders, including clients and prospects

🎯 Requirements

• 8+ years of experience working with healthcare claims data to analyze cost, utilization, and financial performance within a payer or managed care environment • Strong SQL (or similar) skills with proven experience in the ability to independently access, manipulate, and analyze large datasets • Experience analyzing healthcare and utilization data to identify root causes of variation regarding spend/costs; exposure to Medicaid populations preferred • Experience with Medicaid populations and reimbursement structures; familiarity with Commercial populations is a plus • Demonstrated ability to translate medical and clinical data into clear, actionable business insights • Experience building analytical frameworks or financial models that support business decision-making • Prior experience managing analysts is preferred • Bachelor’s degree required; Master’s degree (MBA, MPH, MS) in a related discipline preferred.

🏖️ Benefits

• Paid Time Off • Paid Parental Leave • Medical, dental, vision benefits • 401K with company match • Short- and Long-Term Disability • Group Life Insurance • Tuition reimbursement • Professional development opportunities