Health Care Economist

Health Care Economist

Location: Leesburg, Florida / Remote

Reports to: Chief Financial Officer / Chief Information Officer

Status: Full-time, Exempt / Part-time, Exempt

About the Role

We're looking for a health care economist to help us understand where our money and our outcomes are actually going. You'll dig into claims and cost data, build models that explain why spending moves the way it does, and translate that analysis into decisions leadership can act on — from how we structure value-based contracts to which care interventions are worth scaling.

What You'll Do

• Analyze claims, utilization, and cost data to identify spending trends, cost drivers, and savings opportunities across patient populations
• Build and maintain financial models for value-based care arrangements, including shared savings/loss calculations, benchmark methodology, and risk adjustment
• Evaluate the cost-effectiveness of care management programs and clinical interventions
• Support contract negotiations with payers by modeling financial scenarios and risk exposure
• Track and report performance against quality and financial benchmarks (e.g., CMS ACO benchmarks, MSSP/ACO REACH targets)
• Translate complex quantitative findings into clear recommendations for non-technical stakeholders and leadership
• Monitor regulatory and reimbursement changes and assess their financial impact on the organization
• Partner with compliance, clinical, and finance teams to ensure analyses reflect real operational constraints

What You'll Bring

• Master's or Ph.D. in health economics, economics, health policy, public health, or a related quantitative field
• 3+ years of experience analyzing health care cost and utilization data (payer, provider, ACO, or consulting experience all welcome)
• Strong grounding in statistical and econometric methods (regression analysis, risk adjustment, cost-effectiveness analysis)
• Proficiency with a statistical or data tool such as SAS, R, Stata, or Python, plus advanced Excel
• Working knowledge of Medicare payment models and value-based care arrangements (MSSP, ACO REACH, bundled payments, etc.)
• Ability to explain technical findings to a non-technical audience, in writing and in person
• Comfort working with imperfect, real-world data and drawing defensible conclusions from it

Nice to Have

• Direct experience with CMS ACO benchmarking or shared savings methodology
• Familiarity with claims data formats (837/835) and risk adjustment models (HCC/CMS-HCC)
• Background in home health, post-acute, or primary care economics

Why Join Us

You'll have a direct line from your analysis to real financial and clinical decisions — not a report that sits on a shelf. We need a working leader that owns the decisions made from their work.  Pathways Health Partners is a growing LEAD ACO, MSO, and practice management company in Central Florida.