Upward Health · 14 hours ago
Medical Economics Analyst
New Orleans, Louisiana
Full-time
Onsite
Entry, Mid Level
2+ years expUpward Health is an in-home, multidisciplinary medical group providing whole-person care. The Medical Economics Analyst will support the organization’s value-based care strategy through data-driven insights by analyzing medical claims and financial performance to inform contract strategy with payers and partners.
Health CareMedicalService Industry
Responsibilities
Analyze total cost of care (TCOC), utilization, and quality trends across Upward Health populations
Support financial impact modeling for value-based initiatives, including ER diversion, home-based care, and chronic care management
Identify cost drivers and areas of opportunity using claims, clinical, and operational data
Develop methodologies to assess return on investment (ROI) of clinical interventions
Partner with clinical, finance, and contracting teams to inform payor negotiations and risk adjustment strategy
Produce recurring dashboards and ad hoc analyses for senior leadership, clinical leadership, and health plan partners
Support budgeting and forecasting for risk-based contracts
Collaborate with actuaries and population health teams to refine attribution, benchmarks, and risk scores
Qualification
Required
Bachelor's degree in economics, public health, healthcare administration, finance, statistics, or a related field
2+ years of experience in medical economics, healthcare analytics, or population health analysis
Proficiency with healthcare claims data and common file formats (837, 835, encounter data)
Skilled in SQL, Excel, and at least one analytics tool (e.g., Tableau, Power BI, R, or Python)
Understanding of value-based payment models, including shared savings, capitation, and risk adjustment
Strong business acumen with the ability to present complex data clearly and actionably
Ability to thrive in a fast-paced, mission-driven organization
Advanced Excel and SQL skills required
Proficiency in data visualization tools such as Tableau, Power BI, or QlikView
Strong knowledge of healthcare claims data (medical, pharmacy, eligibility)
Ability to conduct cost/utilization analysis, trend analysis, and predictive modeling
Experience working with Medicare Advantage, Medicaid Managed Care, or Dual Eligible populations
Familiarity with CMS HCC risk adjustment models and RAF score analysis
Exposure to actuarial methods, including trend normalization or IBNR estimation
Ability to translate complex data into actionable insights
Strong written and verbal communication skills for presenting to stakeholders
Experience managing multiple priorities and meeting deadlines in a fast-paced environment
Demonstrates strong critical thinking and problem-solving skills
Uses data to drive decisions and remains objective when interpreting findings
Ensures accuracy in data analysis, coding, and reporting
Works effectively with cross-functional teams including finance, clinical, IT, and operations
Proactively identifies opportunities for improvement or cost containment
Comfortable working in a fast-paced and changing healthcare environment
Maintains high ethical standards, especially when dealing with sensitive patient and financial data
Understanding of managed care, value-based care, and healthcare reimbursement models
Expertise in statistical and financial analysis, particularly related to healthcare cost and utilization
Ability to identify root causes of complex issues and recommend practical solutions
Skilled in extracting, cleaning, and structuring large datasets from multiple sources
Capable of connecting analysis to business goals and influencing organizational strategy
Preferred
Experience with statistical tools such as SAS, R, or Python
Master's preferred (MPH, MHA, MS, MBA)
Provider-side experience strongly preferred
Company
Upward Health
Upward Health is a home-based medical group specializing in primary medical and behavioral care for individuals with complex needs.
501-1000 employees
Funding
Current Stage
Late StageTotal Funding
$28.75MKey Investors
Trinity CapitalHeritage GroupNoro-Moseley Partners
2025-01-16Series C
2025-01-16Debt Financing· $20M
2022-09-13Series B
Leadership Team
Benjamin Hamawy
Chief Financial Officer
Recent News
Business Wire
2025-08-13
2025-01-16
2025-01-16
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