Quantum Health logo
Quantum Health

We believe no one should navigate healthcare alone.

Total Cost of Care Strategy Lead

StrategyStrategyFull TimeRemoteSeniorTeam 1,001-5,000Since 1999H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

21 hours ago

Salary

0

Seniority

Senior

Bachelor Degree5 yrs expEnglish

Job Description

Total Cost of Care Strategy Lead

Quantum Health

• Design and implement frameworks that evaluate provider performance across total cost of care, clinical quality, and downstream utilization • Quantify variation across providers to identify actionable savings opportunities driven by differences in appropriateness, effectiveness, site of service, unit price, and utilization patterns • Develop methodologies to evaluate the downstream impact of provider selection on overall healthcare spend and member outcomes • Translate complex performance and cost dynamics into clear, defensible scoring outputs that are both analytically rigorous and practically actionable • Apply the total cost of care provider scoring framework to develop benefit strategies (e.g., cost-sharing structures, deductible shifts) • Evaluate financial impact of plan changes at the population level and ensure that incentive structures are economically sustainable and aligned to expected savings • Look at what our competitors are doing and identify gaps and opportunity areas (forward looking) • Innovate to anticipate and meet needs of prospective clients/the market • Partner closely with Product, Solution Engineering, Actuarial, and Data teams to inform solution design • Collaborate with market-facing teams on GTM initiatives to refine design to meet the needs of existing clients and to evaluate opportunities for prospective clients • All other duties as assigned

Job Requirements

  • 5–10+ years health economics, actuarial analysis, healthcare analytics, or total cost of care modeling
  • Experience working with healthcare claims data and cost and utilization modeling
  • Experience building value-based models that are deployed in production and used for decision-making
  • Experience in value-based care and actuarial modeling
  • A high degree of personal accountability and trustworthiness
  • A commitment to working within Quantum Health’s policies, values and ethics, and to protecting the sensitive data entrusted to us
  • Preferred Qualifications: Experience in provider performance measurement and episode-based cost modeling
  • Familiarity with Machine Readable Files (MRF) and provider attribution and referral patterns
  • Background in health economics or actuarial concepts

Benefits

  • Health, vision and dental featuring our best-in-class healthcare navigation services
  • Life insurance
  • Legal and identity protection
  • Adoption assistance
  • EAP
  • Teladoc services
  • 401(k) plan with up to 4% employer match and full vesting on day one
  • Paid Time Off (PTO)
  • 7 paid holidays
  • Parental leave
  • Volunteer days
  • Paid sabbaticals
  • Tuition reimbursement up to $5,250 annually
  • Certification/continuing education reimbursement
  • Discounted higher education partnerships
  • Paid trainings and leadership development
  • Casual dress code
  • Open floor plans
  • Full-service dining
  • Free snacks and drinks
  • Complimentary 24/7 fitness center with group classes
  • Outdoor walking paths
  • Game room
  • Notary and dry-cleaning services

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