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Vice President, Medical Economics
Vice President, Medical EconomicsMAXhealth • Tampa, FL, USA
Vice President, Medical Economics

Vice President, Medical Economics

MAXhealth • Tampa, FL, USA
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MaxHealth is seeking a Vice President of Medical Economics to serve as a strategic leader and connector between Analytics, Finance, Operations, and Senior Leadership, ensuring that data-driven insights directly inform financial management, care delivery optimization, and organizational strategy.

We are a full-risk, value-based healthcare organization committed to delivering exceptional outcomes for our patients and partners. Our SQL-based enterprise data warehouse integrates data from multiple payers, care delivery systems, and internal operations to drive insight, accuracy, and performance.

This is a hybrid, Florida based role with a consistence presence at our Tampa Corporate Office needed.

Key Responsibilities :

Strategic Leadership & Collaboration

  • Act as the primary liaison between Finance, Analytics, and Operations to ensure alignment between data insights and financial strategy.
  • Translate complex analytical findings into actionable financial and operational recommendations for senior leadership.
  • Partner with clinical, contracting, and operational teams to identify opportunities for cost containment, quality improvement, and risk optimization.

Medical Economics & Financial Analytics

  • Lead the development and maintenance of medical cost, utilization, and profitability models across lines of business and payers.
  • Oversee attribution, risk adjustment, and reconciliation processes for full-risk and shared-savings arrangements.
  • Evaluate performance drivers such as inpatient utilization, pharmacy trends, physician efficiency, and referral patterns.
  • Direct actuarial and forecasting efforts in collaboration with Finance to ensure accuracy in reserves, accruals, and projections.
  • Manage and interpret complex, service fund-based payer data, including reconciliation of settlements and shared savings.
  • Lead Medicare Risk Adjustment modeling, ensuring accuracy of RAF projections and alignment with coding, documentation, and encounter submissions.
  • Support Medicare Advantage bid analysis, revenue forecasting, and financial scenario modeling.
  • Partner with Contracting on value-based contracting strategy, contract negotiation, financial terms evaluation, and performance monitoring.
  • Data Integrity & Governance

  • Ensure alignment between data warehouse outputs and financial reporting systems.
  • Strengthen source-to-report traceability and auditability of medical economics data.
  • Establish review protocols and sign-off procedures for high-impact reports and dashboards.
  • Leadership & Development

  • Build and mentor a high-performing team of medical economics analysts, actuarial specialists, and financial modelers.
  • Drive a culture of accountability, transparency, and collaboration.
  • Represent the medical economics function in board-level and payer-facing discussions.
  • Qualifications :

    Education & Experience

  • Bachelor's degree required; Master's preferred.
  • 10+ years of experience in medical economics, actuarial analysis, or financial analytics in risk-bearing healthcare.
  • Deep experience with complex payer service fund accounting and settlement workflows.
  • Extensive Medicare Risk Adjustment experience, including RAF modeling and encounter-driven analytics.
  • Demonstrated experience with value-based contracting, including contract design, financial modeling, and performance measurement.
  • Experience with Medicare Advantage bid development, rate analysis, and CMS revenue dynamics.
  • Strong understanding of capitation, risk adjustment, encounter data, and payer reporting.
  • SQL proficiency and experience validating warehouse-driven reporting pipelines.
  • Skills & Attributes

  • Exceptional analytical and communication skills.
  • Ability to translate data into clear business narratives.
  • Strong leadership presence and collaboration mindset.
  • High attention to data quality, accuracy, and governance.
  • This healthcare position earns a competitive wage, depending on experience. We provide fantastic benefits, including health benefits, a 401k plan, life insurance, long-term disability, paid holidays, and PTO (paid time off)!

    ABOUT MAXHEALTH

    MaxHealth is dedicated to simplifying healthcare and ensuring healthier futures. Founded in 2015, MaxHealth is a leading primary care platform focused on providing high-quality, integrated care to adults and senior patients throughout Florida. We provide care for more than 120,000 patients, most of which are beneficiaries of government-sponsored healthcare programs like Medicare, or of health plans purchased on the Affordable Care Act exchange marketplace. MaxHealth is a rapidly growing medical practice with more than 50 clinics spread across central and southern Florida. MaxHealth also partners with independent providers who are like-minded and utilizes its platform to help them provide high-quality care. We are customer-centered; compassionate; results-driven; proactive; collaborative; and adaptable in executing our vision to help patients live their best lives. Our mission is to deliver quality care, a simplified experience, and happiness. One patient at a time.

    #IND123

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