VP, Medical Economics

Job not on LinkedIn

July 28

🎸 Tennessee – Remote

Although this job is listed in Tennessee, this company may be open to hiring remote in other states.

⏰ Full Time

🔴 Lead

👔 Vice President

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Wellvana

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Healthcare Insurance • Fintech • SaaS

Wellvana is a company focused on transforming primary care through value-based care models. They provide essential support to independent physicians and health systems, helping them navigate the challenges associated with transitioning from fee-for-service to value-based payment structures. Wellvana emphasizes a personalized approach, offering data-driven insights and a range of wraparound services designed to improve patient outcomes and reduce healthcare costs. Their aim is to empower healthcare providers to thrive in the evolving landscape of primary care.

201 - 500 employees

Founded 2018

⚕️ Healthcare Insurance

💳 Fintech

☁️ SaaS

💰 $84M Series B on 2023-03

📋 Description

• The Vice President (VP) of Medical Economics will lead a team accountable for defining, executing, and measuring data-driven clinical strategies to generate a positive return on investment and better patient outcomes for our value-based care programs. • This role will analyze healthcare cost and utilization patterns and partner closely with stakeholders across the business to define and operationalize clinical strategies to reduce spend and improve patient outcomes. • This role requires expertise in population health, value-based care, and analytic and data science techniques, as well as strong leadership, communication, and cross-functional collaboration. • Lead a team dedicated to analytics, data science and clinical strategies that create positive ROI for the business and improved patient quality and outcomes. • Engage cross functional team members, including clinical, operational, financial/actuarial, and constituent experience stakeholders, to inform clinical strategies and establish a clinical intervention performance improvement process to achieve our medical cost impact objectives. • Complete extensive market, utilization and clinical research to ensure comprehensive sourcing and evaluation of opportunities. • Prioritize initiatives in our clinical intervention roadmap based on established criteria with clear business case ROI performance. • Evaluate the efficacy of our clinical programs across our populations and networks relative to the resource investment, to ensure a positive return on investment to create value for our business, our provider customers, and our patients. • Partner with team members to leverage advanced statistical and predictive modeling techniques to identify and stratify at-risk patient populations based on their healthcare needs, enabling proactive interventions and personalized care plans. • Provide leadership, guidance, and mentorship to the medical economics team. • Recruit future team members and facilitate career development opportunities. • Stay abreast of evolving regulatory requirements related to program offerings (Medicare Advantage, MSSP, etc.), population health management and value-based care, ensuring compliance with relevant laws and regulations. • Continuously monitor industry trends, emerging technologies, and best practices in population health management and value-based care analytics and proactively integrate them into the medical economics team strategy and roadmap.

🎯 Requirements

• Advanced degree (e.g., Master's or Ph.D.) in analytics, data science, health informatics, or a related field. • Extensive experience (10+ years) in healthcare analytics, with a focus on population health management and value-based care. • Clinical training or experience a plus. • The ideal candidate has worked previously with a payer, ACO or risk bearing entity. • Proven track record of driving successful analytics initiatives and achieving measurable outcomes in population health management and value-based care. • Ability to lead a diverse team to execute on a range of analytics strategies and initiatives and to effectively collaborate with cross-functional teams and resources. • Ability to hold staff accountable to productivity, quality and financial targets. • Strong knowledge of healthcare data sources, including electronic health records (EHRs), claims data, and other relevant data sets. • Proficiency in statistical analysis, predictive modeling, and data science tools and techniques. • Deep understanding of population health management concepts, risk stratification methodologies, and value-based care reimbursement models. • Experience with healthcare analytics platforms and technologies, such as data warehouses, business intelligence tools, and machine learning frameworks. • Strong leadership skills with the ability to effectively communicate complex analytics concepts to diverse audiences, including executive leadership, clinicians, and non-technical stakeholders. • Excellent problem-solving and critical thinking abilities, with a focus on defining and executing cost-effective enterprise strategies. • Familiarity with healthcare regulatory and related requirements, such as HIPAA, PHI, HCC, ICD-10, QPP, etc. and a commitment to maintaining data privacy and security.