AVP, Managed Care Contracting, Medical Economics

TriEdge Investments

Lead Managed Care Contracting & Medical Economics unit at Salud Healthcare, transforming value-based care through data-driven insights and technology. Conduct quantitative analysis and engage with payor partners.

Posted 6/23/2026full-timeRemote • 🇺🇸 United StatesLead💰 $150,000 - $200,000 per yearWebsite

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

quantitative analysisrisk underwritingmedical codingclaims data analysisIBNR modelssensitivity modelsfinancial forecastingbudgetinghealthcare economicsactuarial science

Soft Skills

effective communicationpresentation skillsanalytical abilitiescross-functional collaborationclient-facing experience

Tools & Technologies

databasesMicrosoft OfficeExcelWordPowerPoint

Certifications & Qualifications

ASA designationFSA designation

Industry Keywords

value-based careP4Qcapitationshared savings modelsMedicareMedicaidcommercial insuranceexchange lines of businessmanaged carepayor JOC meetings

About the role

Key responsibilities & impact

Apply quantitative analysis to underwrite risk across various value-based care contracts, including but not limited to P4Q, professional fee capitation, two-sided shared savings models, and global capitation arrangements.
A strong understanding of healthcare terminology and principles, including medical coding, claims data, and broader medical economic trends, including Part A, B, and D segments.
Strong proficiency in being able to use databases and tools to query, interpret, and build sensitivity models to evaluate risk propensity.
Ability to take claims data and develop IBNR models to inform a prediction of future paid claims experience.
Partner cross-functionally with internal stakeholders on legal implications of managed care negotiations, financial forecasting and budgeting, and operational delivery tactics.
Effective verbal, written, and presentation skills to wide audiences, including physicians, executive management, and external stakeholders.
Responsible for participating in payor JOC meetings to facilitate alignment on performance targets and goals.

Requirements

What you’ll need

Bachelor’s degree (B.A.) in actuarial science, healthcare economics, quantitative analysis, mathematics, or a closely related field; a statistics background would prove helpful in this role
Experienced healthcare economist or actuary with a payor or benefits consultant background.
ASA or FSA designation required, or progress towards such designations.
Experience in client-facing roles
Strong analytical abilities and proficiency with Microsoft Office, especially Word, Excel, and PowerPoint.
Experience across different health insurance products is highly preferred, including: Medicare, Medicaid, commercial, and exchange lines of business.

Benefits

Comp & perks

Health, dental, and vision insurance.
401(k)
Paid time off and company holidays.
Opportunity to shape the future of healthcare technology within a rapidly growing value-based care organization.