Healthcare Economics & Cost Analytics Lead

Healthfirst; New York (NY); Hybrid; USD 103,000 - 149,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

401k contributions

Incentive and recognition programs

Job summary

Healthfirst is seeking a Manager, Total Cost of Care, to drive analytics across the Healthfirst portfolio. The role focuses on healthcare economics, medical cost containment, provider network informatics, and reimbursement accuracy with a strong emphasis on cross-functional impact.

The candidate will lead data-driven cost and utilization analyses, build interactive financial models, and guide decision-making for Finance, Claims, Pharmacy, and Network teams.

Qualifications

• Bachelor’s degree from an accredited institution.
• Hybrid work schedule requiring in-office presence at 100 Church Street, NYC on Tue–Thu.
• At least six years in healthcare analytics, with three in contract evaluation, medical economics, or reimbursement model design.

Responsibilities

• Monitor medical cost and utilization trends and provide actionable insights.
• Develop savings analyses and financial models for cost trend reduction initiatives.
• Prioritize cost mitigation activities across business areas.
• Provide data-driven analysis to Finance, Claims, Pharmacy, and Network teams to support decisions.
• Optimize reimbursement terms and standardize provider agreement language.
• Identify reimbursement outliers and assess payer methodologies.
• Lead development of tools for hospital and provider reimbursement management.
• Develop profitability dashboards by product.
• Stay updated on Medicaid/Medicare reforms and their impact.

Skills

Healthcare analytics

Contract evaluation

Medical economics

Actuarial

Healthcare reimbursement

Leadership

Project management

Data analysis

Excel

Communication

Education

Bachelor’s degree

Tools

SAS

SQL

Tableau

Python

Job description

Healthfirst is seeking a Manager, Total Cost of Care, to drive analytics across the Healthfirst portfolio. The role focuses on healthcare economics, medical cost containment, provider network informatics, and reimbursement accuracy with a strong emphasis on cross-functional impact.

The candidate will lead data-driven cost and utilization analyses, build interactive financial models, and guide decision-making for Finance, Claims, Pharmacy, and Network teams.