VP of Medical Economics
Daymark Health · Boston, MA · 1 mo ago
On-siteManagement$190/hrFull-time
About the role
As Daymark's first VP of Medical Economics, you'll be the first dedicated medical economics hire, sitting on the senior leadership team. You'll own the full cost-of-care analytics function, building everything from payer-facing savings dashboards to internal utilization reporting on top of Daymark's Tuva data infrastructure.
Core responsibilities
- Contract performance analytics (including shared savings calculations, baseline construction, and serving as Daymark's primary analytical counterpart to health plan actuarial teams)
- Savings initiative modeling (across drug episode groupers, clinical pathway adherence, biosimilar conversion, weight-based dosing, and site-of-care shifts)
- Payer growth support (including opportunity assessments, contract term design, and defending methodology in negotiations)
- AI and advanced analytics (leading the medical economics AI strategy and building agentic workflows for claims analytics and EHR monitoring)
Leading key savings initiatives
- Drug-specific groupers: Design and maintain claims-based drug episode groupers attributing spend by cancer type, line of therapy, and regimen to enable consistent cross-provider and cross-payer comparisons.
- Clinical pathway analytics: Build the analytical foundation for Daymark's clinical pathway guidelines, defining evidence-based, cost-efficient regimen standards by cancer type, line of therapy, and patient cohort; develop provider-level adherence benchmarks that identify outlier prescribing patterns and inform pathway refinement.
- Biosimilar opportunity identification: Build utilization analytics to identify biosimilar conversion opportunities across the oncology drug portfolio; quantify per-episode and savings potential and track adoption against benchmarks.
- Weight-based dosing compliance: Develop claims-based proxies and, where EHR data is available, patient-level BSA-to-HCPCS unit reconciliation to flag overdosing and reduce within-type unit costs.
- Site-of-care analytics: Model the financial impact of site-of-care shifts (hospital outpatient to physician office; office to home infusion) and track migration.
Reporting Infrastructure
- Build and own Daymark's internal and external reporting stack, from payer-facing savings dashboards to internal trend and utilization reports.
- Collaborate with Product and Engineering on data model and agentic workflow development to support medical economics and reporting infrastructure.
AI & Advanced Analytics
- Lead Daymark's medical economics AI strategy, identifying high-value use cases for LLM and agentic workflows in claims analytics and reporting automation.
- Build AI tooling infrastructure and develop agentic EHR monitoring workflows to support proactive care pathway identification.
Payer Growth Contracting Support
- Support claims-based opportunity assessments for new payer partnerships, including cost and utilization benchmarking and savings lever identification
- Support contract term design, including performance guarantee structure, baseline methodology, and savings-sharing mechanics
- Serve as Daymark's analytical voice in payer negotiations, defending savings estimates, attribution methodology, and other term requirements
Team & Organization
- Build and lead the medical economics and reporting function, operating initially as a hands-on individual contributor while developing the hiring roadmap and team structure
- Collaborate with Daymark's actuary team on modeling, trending, and actuarial review
- Serve as an SLT member with a voice in product, clinical, and growth strategy decisions
Compensation
$190-$230k depending on experience and location