VP of Medical Economics

• Own total cost-of-care analytics across all payer contracts, including PMPM, utilization, and service grouper categories on top of Tuva infrastructure.
• Develop shared savings calculations, baseline and trend construction, and member mix and service mix adjustment approaches that normalize costs across cancer types and acuity cohorts, ensuring adjustments are transparent, reproducible, and defensible to plan counterparts.
• Lead reporting with payer partners and serve as Daymark's primary analytical counterpart to plan medical economics and actuarial teams.

• 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.

• 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.

• 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.

• 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

• 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