Director, Medical Economics/Medical Expense Actuary

Position Overview

• Location Type: Not Specified
• Job Type: Full time
• Salary: Not Specified

At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. We are building a new kind of all-in-one healthcare company, integrating compassion, health insurance, clinical care, service, and technology to deliver a complete and integrated healthcare solution. Founded in 2017, Devoted Health serves members across the United States.

Role Description

The Director of Medical Economics will drive enterprise-wide cost improvement initiatives by collaborating with cross-functional stakeholders to identify opportunities for cost optimization while maintaining high standards of quality and patient care. This leader will work closely with market leadership, payment integrity and claims, network, engineering, Devoted Medical, the actuarial team, and executive leadership to inform and drive key operational and strategic decisions. The ideal candidate will have a strong background in healthcare economics, data analysis, and strategic planning, with a deep understanding of healthcare delivery systems and reimbursement models.

Key Responsibilities and Expectations

• P&L Ownership: Drive P&L ownership for medical costs across the organization.
• Medical Expense Management: Lead a cross-functional process for identifying, quantifying, and tracking medical expenses and their impact on earnings.
• Performance and Metrics: Experience in a public company setting, identifying and managing medical cost drivers effectively.
• Financial Acumen: Possess the skills of a Medical Expense Actuary with operational, financial planning, and corporate finance analytical expertise.
• Process Ownership & Collaboration: Build and drive a structured process for measuring and quantifying medical expenses with regular cadence, engaging with Devoted Medical, Market, Network, Ops, Claims and PI, and data teams.
• Financial Performance Driving: Link medical expense management directly to overall financial performance, providing forward visibility on forecasted performance versus financial targets.
• Strategic Initiatives: Develop and implement cross-functional, strategic initiatives to improve medical cost and quality, including provider reimbursement strategies, utilization management programs, and value-based payment models.
• Data Analysis: Conduct in-depth analyses of healthcare utilization patterns, cost drivers, and performance metrics to identify areas for improvement and cost savings.
• Stakeholder Collaboration: Collaborate closely with internal stakeholders, including clinical leadership, actuarial, accounting, and finance operations.

Company Values

• Treat every member like family.
• Build for a rolling 20-year time horizon.
• Operate as a paragon of hypercompliance.