Matter Health

Manager, Medical Economics

Nashville | Remote · Full-time

Sponsorship not specifiedDetected 21 days ago

Data VisualizationStatisticsFinancial AnalysisExcelProcess ImprovementLeadershipCommunicationProblem SolvingFinancial Reporting

About the role

The Manager, Medical Economics is responsible for Matter Health's membership and premium reconciliation functions.
This leader ensures enrollment, eligibility, and capitation revenue are accurately reconciled across payer files, internal systems, and financial reporting processes.
The ideal candidate combines deep healthcare analytics expertise with managed care knowledge, and thrives in a fast-paced, high-growth setting.

Lead the end-to-end membership reconciliation process, ensuring that enrollment, eligibility, and capitation payments are accurately tracked and reconciled across payer files, internal systems, and the general ledger.
Build and maintain business rules, controls, and data flows supporting member-month counts and premium accrual processes.
Partner with Finance, Operations, and EIM teams to identify root causes and implement upstream data improvements.
Support month-end close activities by validating premium revenue and explaining membership and premium variances.
Design scalable reconciliation processes and prepare to support the growth of an analyst team.
Fully own membership reconciliation.
Fully own both membership and premium reconciliation functions.

Experience with enrollment and eligibility data, including payer files such as 834/820 transactions.
Advanced Excel proficiency and the ability to independently analyze complex datasets.
Ability to present analytical findings and recommendations to leadership.
Experience with SQL.
Experience in premium reconciliation processes.
Bachelor's degree in Statistics, Mathematics, Economics, Computer Science, Healthcare Management, or a related field.
7+ years of experience in healthcare analytics, medical economics, or premium/membership reconciliation.
Experience with healthcare, managed care, health plans, value-based care organizations, or healthcare analytics environments.
Strong expertise in Medicare Advantage, healthcare analytics, and/or medical economics.
In-depth understanding of healthcare financial concepts, including PMPM, member months, capitation, premium accrual, and eligibility.
Strong analytical, problem-solving, communication, and relationship-building skills.
Managed care organization experience.

Medical, dental, and vision coverage
Employer-funded HSA and FSA options
Employer-paid life and disability insurance
Voluntary illness, accident, and hospitalization coverage
Access to Matter Health's in-person and virtual care services
Financial wellness resources and support
Up to 4 weeks of PTO
Matter Health delivers primary and preventive healthcare directly to older adults living in public housing communities.
Gain foundational knowledge of Matter Health's systems, data sources, and reconciliation processes.
Quantify revenue at risk and collaborate with internal teams and health plans to recover discrepancies.
Lead gap analysis and process improvement efforts related to medical expense data.

to improve healthcare access by meeting patients where they are and building trusted relationships within the communities we serve.
We are rapidly expanding across Tennessee and are seeking mission-driven professionals who thrive in fast-paced, people-centered environments.
Total Healthcare.
Where you live.

Matter Health is committed to building a diverse and inclusive workplace. We welcome applicants from all backgrounds and experiences, and foster an environment where every team member feels valued, respected, and supported.
Matter Health is committed to building a diverse and inclusive workplace.
We welcome applicants from all backgrounds and experiences, and foster an environment where every team member feels valued, respected, and supported.

This listing is sourced directly from Matter Health's careers page and normalized into a canonical job model.