Manager, Medical Economics in Nashville, Tennessee at Matter Health

About Matter Health

Matter Health delivers primary and preventive healthcare directly to older adults living in public housing communities.

Our mission is simple: improve healthcare access by meeting patients where they are and building trusted relationships within the communities we serve. We are growing rapidly across Tennessee and are building a team of mission-driven professionals who thrive in fast-paced, people-centered environments.

Total Healthcare. Where you live.

About the Role

The Manager, Medical Economics owns Matter Health's membership and premium reconciliation functions, ensuring enrollment, eligibility, and capitation revenue accurately reconcile across payer files, internal systems, and financial reporting processes.

This individual will serve as the subject matter expert for membership and premium economics, partnering closely with Finance, Enterprise Information Management (EIM), and Operations to identify discrepancies, recover revenue at risk, and improve data accuracy and integrity across the organization.

The ideal candidate combines strong healthcare analytics experience with managed care knowledge and thrives in a fast-paced, high-growth environment.

What You'll Do

• Own the end-to-end membership reconciliation process, ensuring enrollment, eligibility, and capitation payments reconcile accurately across payer files, internal systems, and the general ledger.
• Investigate and resolve membership and premium variances, including retroactive additions, terminations, and rate changes.
• Quantify revenue at risk and partner with internal teams and health plans to recover discrepancies.
• Build and maintain business rules, controls, and data flows supporting member-month counts and premium accrual processes.
• Partner closely with Finance, Operations, and Enterprise Information Management teams to identify root causes and implement upstream data improvements.
• Produce monthly reconciliation reporting and dashboards that provide leadership visibility into membership, PMPM, and premium trends.
• Support month-end close activities by validating premium revenue and explaining membership and premium variances.
• Conduct independent analyses and present findings and recommendations to leadership.
• Help establish scalable reconciliation processes and prepare to support future analyst team growth.

What Success Looks Like

First 90 Days

• Gain baseline knowledge of Matter Health systems, data sources, and reconciliation processes.
• Assume ownership of the membership reconciliation process.
• Conduct initial gap analyses and identify opportunities for improvement.

Within 6 Months

• Fully own membership reconciliation activities.
• Begin assuming responsibility for premium reconciliation processes.

Within 12 Months

• Fully own both membership and premium reconciliation functions.
• Lead gap analysis efforts related to medical expense data requirements and process improvements.

Required Qualifications

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

Preferred Qualifications

• SQL experience.
• Experience with premium reconciliation processes.
• Managed care organization experience.
• Experience building dashboards in Power BI and/or Tableau.
• Knowledge of value-based care analytics and risk-based reimbursement models.
• Previous leadership or team management experience.

Why Matter Health

We believe that where someone lives should never determine the care they receive. Every team member at Matter Health plays a role in improving healthcare access for older adults who have historically been underserved by traditional healthcare systems.

This is not just a mission statement — it is the work we do every day.

Total Healthcare. Where you live.

Working at Matter Health

We’re committed to supporting the whole person — at work and beyond. Benefits for full-time team members begin the first of the month following your start date.

Health & Wellness

• 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 Security

• Competitive compensation

• 401(k) with company match beginning at day 60

• Access to financial wellness resources and support

Time Away

• Up to 4 weeks of PTO

• 10 paid company holidays

• 2 volunteer days annually to support causes meaningful to you

Eligibility is based on full-time employment status. Additional details will be shared during the interview process.

Equal Opportunity Employer

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