Healthcare Economics Strategist

Description: Emboss Specialty is seeking dynamic, motivated candidates with a high self-standard that is evident in all aspects of their work. The ideal candidate has demonstrated a track record conducting complex operational and financial analysis in the healthcare space, with specific depth in medical expense/medical cost trend analysis (e.g., PMPM trend, utilization vs. unit cost decomposition, MLR drivers, cost-of-care levers). This person partners directly with clinical, network, finance, and executive leadership – running hypothesis-driven analyses, building the business case for interventions, and presenting findings in clear, decision-ready formats similar to a management consulting engagement.

Key Responsibilities: Medical Expense & Financial Analysis Lead complex, end-to-end analyses of medical expense trend – decomposing PMPM cost drivers into utilization, unit cost, mix, and severity components across lines of business. Build and maintain financial models that quantify the gross margin, MLR, and cost-of-care impact of clinical, network, and operational initiatives. Partner with Finance and Analytics teams to validate medical cost assumptions, forecast trend, and stress-test scenarios for budget, forecast, and board reporting cycles. Design enterprise dashboards (utilization, cost-of-care, network performance, and quality) using SQL, Excel, and Power BI to make medical expense drivers transparent to leadership. Collaborate with Finance to assess the economic impact of business initiatives, linking operational and clinical data outcomes to gross margin, MLR, cost-of-care, and P&L implications. Consulting-Style Operational Analysis Structure ambiguous, high-stakes business questions into clear analytical frameworks, hypotheses, and workplans – in the manner of an internal management consultant. Conduct root-cause and variance analysis on operational performance (utilization management, care management, network access) to identify actionable cost and quality levers. Build the business case (ROI, payback, sensitivity analysis) for proposed operational or clinical interventions, and pressure-test assumptions with stakeholders. Translate complex, multi-source healthcare datasets into crisp, executive-level narratives, recommendations, and decision materials. Stakeholder Partnership & Executive Advisory Serve as a trusted analytics advisor to clinical, network, finance, and executive leadership on medical expense performance and improvement opportunities. Partner with clinical and operational leadership to define KPIs and financial targets aligned to enterprise value creation goals. Lead cross-functional collaboration with IT, data engineering, Finance, and Analytics to strengthen data architecture supporting medical expense reporting. Present findings and recommendations directly to senior stakeholders in clear, decision-ready formats, and guide prioritization of the analytics agenda. Mentor junior analysts and help build a consulting-caliber analytics capability across the team.

Qualifications: Bachelor’s degree (or equivalent experience) in finance, economics, health informatics, data analytics, business, or a related field; MBA or MHA a plus. 5+ years of experience conducting complex operational and financial analysis, ideally including time in a consulting, healthcare finance, or actuarial-adjacent role. 3+ years of experience analyzing medical expense/medical cost data specifically – claims, PMPM trend, MLR, utilization management/prior authorization, care management, and quality measures. Financial planning and analysis literacy, including the ability to interpret business performance drivers, build Excel-based financial models, and communicate P&L impacts of analytics findings. Advanced proficiency in SQL, Excel (including financial modeling), and Power BI. Strong understanding of healthcare economics, clinical workflows, and the levers that drive medical cost and utilization performance. Demonstrated ability to structure ambiguous problems, build the analytical case for change, and translate findings into executive-level insight and recommendations – consulting toolkit strongly preferred (e.g., MECE frameworks, hypothesis-driven analysis, storylining). Excellent stakeholder engagement, executive communication, and strategic problem-solving skills. Self-starter comfortable managing multiple high-visibility priorities independently and under tight timelines.

Preferred Qualifications: Prior experience at a management consulting firm, health plan actuarial/finance team, or healthcare-focused advisory practice. Experience mentoring analysts and leading analytics workstreams or initiatives. Experience with data science tools and programming languages such as Python or R.

Location: Position is remote and the location of candidate is flexible within the U.S. Travel Required No. Behaviors Preferred Enthusiastic: Shows intense and eager enjoyment and interest Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well Innovative: Consistently introduces new ideas and demonstrates original thinking Team Player: Works well as a member of a group Motivations Preferred Ability to Make an Impact: Inspired to perform well by the ability to contribute to the success of a project or the organization Education Preferred Bachelors or better.

Experience Required: Financial planning and analysis literacy, including the ability to interpret business performance drivers, build Excel-based financial models, and communicate P&L impacts of analytics findings 5-8 years: Experience conducting complex operational and financial analysis, ideally including time in a consulting, healthcare finance, or actuarial-adjacent role Advanced proficiency in SQL, Excel (including financial modeling), and Power BI. 3-10 years: Experience analyzing medical expense/medical cost data specifically – claims, PMPM trend, MLR, utilization management/prior authorization, care management, and quality measures

Equal Opportunity Employer: This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.