Total Cost of Care Strategy Lead

Quantum Health

Total Cost of Care Strategy Lead at Quantum Health driving savings through healthcare cost optimization. Develop models to evaluate cost drivers and support the Embold Health division with actionable insights and strategies.

Posted 6/20/2026full-timeRemote • 🇺🇸 United StatesSeniorWebsite

About the role

Key responsibilities & impact

Design and implement frameworks that evaluate provider performance across total cost of care, clinical quality, and downstream utilization
Quantify variation across providers to identify actionable savings opportunities driven by differences in appropriateness, effectiveness, site of service, unit price, and utilization patterns
Develop methodologies to evaluate the downstream impact of provider selection on overall healthcare spend and member outcomes
Translate complex performance and cost dynamics into clear, defensible scoring outputs that are both analytically rigorous and practically actionable
Apply the total cost of care provider scoring framework to develop benefit strategies (e.g., cost-sharing structures, deductible shifts)
Evaluate financial impact of plan changes at the population level and ensure that incentive structures are economically sustainable and aligned to expected savings
Look at what our competitors are doing and identify gaps and opportunity areas (forward looking)
Innovate to anticipate and meet needs of prospective clients/the market
Partner closely with Product, Solution Engineering, Actuarial, and Data teams to inform solution design
Collaborate with market-facing teams on GTM initiatives to refine design to meet the needs of existing clients and to evaluate opportunities for prospective clients
All other duties as assigned

Requirements

What you’ll need

5–10+ years health economics, actuarial analysis, healthcare analytics, or total cost of care modeling
Experience working with healthcare claims data and cost and utilization modeling
Experience building value-based models that are deployed in production and used for decision-making
Experience in value-based care and actuarial modeling
A high degree of personal accountability and trustworthiness
A commitment to working within Quantum Health’s policies, values and ethics, and to protecting the sensitive data entrusted to us
Preferred Qualifications: Experience in provider performance measurement and episode-based cost modeling
Familiarity with Machine Readable Files (MRF) and provider attribution and referral patterns
Background in health economics or actuarial concepts

Benefits

Comp & perks

Health, vision and dental featuring our best-in-class healthcare navigation services
Life insurance
Legal and identity protection
Adoption assistance
EAP
Teladoc services
401(k) plan with up to 4% employer match and full vesting on day one
Paid Time Off (PTO)
7 paid holidays
Parental leave
Volunteer days
Paid sabbaticals
Tuition reimbursement up to $5,250 annually
Certification/continuing education reimbursement
Discounted higher education partnerships
Paid trainings and leadership development
Casual dress code
Open floor plans
Full-service dining
Free snacks and drinks
Complimentary 24/7 fitness center with group classes
Outdoor walking paths
Game room
Notary and dry-cleaning services

ATS Keywords

✓ Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

health economicsactuarial analysishealthcare analyticstotal cost of care modelingcost and utilization modelingvalue-based modelsprovider performance measurementepisode-based cost modelingdata analysisquantitative analysis

Soft Skills

personal accountabilitytrustworthinesscollaborationinnovationcommunicationproblem-solvinganalytical thinkingstrategic thinkingadaptabilityclient-focused