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Director, MedEcon
Location
United States
Posted
87 days ago
Salary
$135K - $231K / year
Seniority
Lead
No structured requirement data.
Job Description
Director, MedEcon
Waymark
About Waymark Waymark is a mission-driven team of healthcare providers, technologists, and builders working to transform care for people with Medicaid benefits. We partner with communities to deliver technology-enabled, human-centered support that helps patients stay healthy and thrive. We’re designing tools and systems that bring care directly to those who need it most—removing barriers and reimagining what’s possible in Medicaid healthcare delivery. Our Values At Waymark, our values are the foundation of how we work, grow, and support one another: - Bold Builders: We tackle the toughest challenges in care delivery by harnessing the power of community and technology. - Humble Learners: We seek feedback, embrace diverse perspectives, and welcome challenges to our assumptions. - Experiment to Improve: We use data to inform decisions and continuously assess our performance. - Focused Urgency: Our mission drives us to act swiftly and relentlessly in pursuit of meaningful results. If this resonates with you, we invite you to bring your creativity, energy, and curiosity to Waymark. About this role As the Director of MedEcon, you will be a key leader in the organization covering claims-based analysis, actuarial science, and medical economics. This is a foundational finance role that requires both strategic vision and hands-on execution. You will be responsible for building out the next generation of actuarial and medical economics capabilities while simultaneously delivering critical analyses that drive our business and clinical strategy.While your actuarial knowledge is important, your core focus will be combining financial data, claims data, and operational performance data to drive insightful analysis that help push the Waymark care model forward through deep collaboration with analytics. Reporting to the Chief Revenue Officer (acting CFO), you will lead financial performance measurement and forecasting for value-based contracts. You will be a technical expert who ensures we accurately forecast performance, understand cost trends, identify opportunities for clinical impact, and communicate our value to partners. This role requires someone who can both develop sophisticated analyses themselves and build the infrastructure to scale these capabilities. You will work at the intersection of finance, partnerships, clinical operations, and analytics—translating complex actuarial and medical economics concepts into actionable insights for both internal stakeholders and external health plan and health system partners. You must be as comfortable building an IBNR model or conducting a cost trend analysis as you are presenting financial projections to a health plan CFO or helping to guide contract negotiations. Understanding the nuances of Medicaid is essential and an added bonus if you have experience with Medicare Advantage and Dual Eligibles. Healthcare data in these populations can be incomplete and inconsistent, and the regulatory environment is complex and varies by state. Your deep expertise in these markets, combined with your ability to build robust analytical frameworks despite data challenges, will be critical to our success. Key Responsibilities - Own savings forecasts and monthly financial close for all value-based contracts, including shared savings accruals, reserves, and IBNR development - Build and maintain financial models capturing performance drivers under MLR-based and RCT-based contract structures; monitor cost trends and provide early warnings of variances with recommended actions - Serve as the technical authority on total cost of care projections, conducting and reviewing sophisticated analyses, cost trend studies, and actuarial modeling as needed - Lead year-end contract reconciliation with health plan actuaries and provide actuarial/financial guidance during contract negotiations - Develop underwriting frameworks (MLR targets, performance guarantees, risk corridors) and build methodologies to accurately measure organizational performance across contract structures - Perform deep-dive cost trend analyses to identify clinical impact opportunities; generate insights that drive clinical model innovation and support strategic planning across market opportunities and growth scenarios - Serve as the primary technical counterpart to health plan actuaries during data validation, reconciliation, and negotiations - Lead discussions to resolve methodology differences and communicate findings clearly to non-technical stakeholders - Develop compelling value narratives and analytical exhibits that translate complex medical economics findings into actionable recommendations - Build, grow, and lead a best-in-class medical economics and actuarial function - Develop analytical tools, data infrastructure, and reporting frameworks that improve team efficiency and scale capabilities - Dive deep into data quality issues and work cross-functionally to resolve discrepancies; write analytical memos and reports that communicate findings to senior leadership Minimum Qualifications - Advanced degree in a quantitative field (actuarial science, statistics, mathematics, economics, public health, or related) - 10+ years of progressive experience in health actuarial science or medical economics, with at least 3-5 years in a leadership role - Demonstrable expertise in Medicaid, including capitation, risk adjustment, MLR requirements, and regulatory frameworks - Proven track record with value-based care arrangements, shared savings contracts, and risk-bearing models, including contract underwriting, performance forecasting, and financial reconciliation - Expert-level proficiency in actuarial and medical economics methodologies (reserving, pricing, trend analysis, total cost of care modeling); strong SQL, Python, and/or R skills; advanced Excel/financial modeling; and experience with large, complex healthcare datasets - Demonstrated ability to build and lead high-performing analytical teams in growth-stage organizations, with exceptional communication skills across technical and non-technical audiences - Equal parts strategic thinker and hands-on executor — able to build vision and infrastructure while personally conducting sophisticated analyses - Comfortable with ambiguity, fast-moving priorities, and building effective cross-functional partnerships Preferred Qualifications - ASA credential or meaningful progress toward FSA - Deep Medicaid managed care experience, including state program variations, CMS regulations, and actuarial standards of practice (ASOP) - Understanding of care delivery models, clinical quality measures, and the relationship between clinical interventions and medical costs - Experience building analytical functions from the ground up in early-stage or high-growth companies - Genuine commitment to improving care for underserved populations and closing health equity gaps Salary Range US Employees in San Francisco/Bay Area, New York City - $175,000 - $231,000 US Employees in Boston, Los Angeles, Seattle, Washington DC - $161,000 - $212,000 US Employees in Arlington, Denver, San Diego, Sacramento - $154,000 - $203,000 US Employees in Albany, Atlanta, Austin, Baltimore, Central/Southern, Charlotte, Chicago, Dallas/Fort Worth, Detroit, Houston, Las Vegas, Miami, Milwaukee, Philadelphia, Portland, Research Triangle, Salt Lake City, Twin Cities - $140,000 - $185,000 US Employees in Baton Rouge, Birmingham, Charleston, Cincinnati, Cleveland, Daytona Beach, Indianapolis, Nashville, New Orleans, Omaha, Phoenix, Pittsburgh, St. Louis, Tampa - $135,800 - $179,000 In addition to salary, we offer a comprehensive benefits package. Here’s what you can expect: Stock Options: Opportunity to invest in the company’s growth. Work-from-Home Stipend: A dedicated stipend for your first year to help set up your home office. Medical, Vision, and Dental Coverage: Comprehensive plans to keep you and your family healthy. Life Insurance: Basic life insurance to give you peace of mind. Paid Time Off: 20 vacation days, accrued over the year, plus 11 paid holidays. Parental Leave: 16 weeks of paid leave for birthing parents after six months of employment, and 8 weeks of bonding leave for non-birthing parents. Retirement Savings: Access to a 401(k) plan with a company contribution, subject to a vesting schedule. Commuter Benefits: Convenient options to support your commute needs. Professional Development Stipend: A dedicated stipend supports professional development and growth. Offer of employment is contingent upon successful completion of a background check. Don’t check off every box in the requirements listed above? Please apply anyway! Studies have shown that some of us may be less likely to apply to jobs unless we meet every single qualification. Waymark is dedicated to building a supportive, equal opportunity, and accessible workplace that fosters a sense of belonging – so if you’re excited about this role but your past experience doesn’t align perfectly with every preferred qualification in the job description, we encourage you to still consider submitting an application. You may be just the right candidate for this role or another one of our openings!
Job Requirements
- Advanced degree in a quantitative field (actuarial science, statistics, mathematics, economics, public health, or related).
- 10+ years of progressive experience in health actuarial science or medical economics, with at least 3-5 years in a leadership role.
- Demonstrable expertise in Medicaid, including capitation, risk adjustment, MLR requirements, and regulatory frameworks.
- Proven track record with value-based care arrangements, shared savings contracts, and risk-bearing models, including contract underwriting, performance forecasting, and financial reconciliation.
- Expert-level proficiency in actuarial and medical economics methodologies (reserving, pricing, trend analysis, total cost of care modeling); strong SQL, Python, and/or R skills; advanced Excel/financial modeling; and experience with large, complex healthcare datasets.
- Demonstrated ability to build and lead high-performing analytical teams in growth-stage organizations, with exceptional communication skills across technical and non-technical audiences.
- Equal parts strategic thinker and hands-on executor — able to build vision and infrastructure while personally conducting sophisticated analyses.
- Comfortable with ambiguity, fast-moving priorities, and building effective cross-functional partnerships.
- Preferred Qualifications
- ASA credential or meaningful progress toward FSA.
- Deep Medicaid managed care experience, including state program variations, CMS regulations, and actuarial standards of practice (ASOP).
- Understanding of care delivery models, clinical quality measures, and the relationship between clinical interventions and medical costs.
- Experience building analytical functions from the ground up in early-stage or high-growth companies.
- Genuine commitment to improving care for underserved populations and closing health equity gaps.
- Salary Range
- US Employees in San Francisco/Bay Area, New York City - $175,000 - $231,000
- US Employees in Boston, Los Angeles, Seattle, Washington DC - $161,000 - $212,000
- US Employees in Arlington, Denver, San Diego, Sacramento - $154,000 - $203,000
- US Employees in Albany, Atlanta, Austin, Baltimore, Central/Southern, Charlotte, Chicago, Dallas/Fort Worth, Detroit, Houston, Las Vegas, Miami, Milwaukee, Philadelphia, Portland, Research Triangle, Salt Lake City, Twin Cities - $140,000 - $185,000
- US Employees in Baton Rouge, Birmingham, Charleston, Cincinnati, Cleveland, Daytona Beach, Indianapolis, Nashville, New Orleans, Omaha, Phoenix, Pittsburgh, St. Louis, Tampa - $135,800 - $179,000
Benefits
- Stock Options: Opportunity to invest in the company’s growth.
- Work-from-Home Stipend: A dedicated stipend for your first year to help set up your home office.
- Medical, Vision, and Dental Coverage: Comprehensive plans to keep you and your family healthy.
- Life Insurance: Basic life insurance to give you peace of mind.
- Paid Time Off: 20 vacation days, accrued over the year, plus 11 paid holidays.
- Parental Leave: 16 weeks of paid leave for birthing parents after six months of employment, and 8 weeks of bonding leave for non-birthing parents.
- Retirement Savings: Access to a 401(k) plan with a company contribution, subject to a vesting schedule.
- Commuter Benefits: Convenient options to support your commute needs.
- Professional Development Stipend: A dedicated stipend supports professional development and growth.
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