Healthcare Economics Strategist

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.