Tennessee Licensed Medical Economics Manager

Job Summary

To support a growing healthcare organization, the full-time salaried Tennessee Licensed Medical Economics Manager will manage membership and premium reconciliation processes, ensuring accurate enrollment and capitation revenue while collaborating with Finance and Operations teams remotely.

Key responsibilities

• Own the end-to-end membership reconciliation process and ensure accurate enrollment and capitation payments
• Investigate and resolve membership and premium variances, partnering with internal teams to recover discrepancies
• Produce monthly reconciliation reports and dashboards for leadership visibility into membership trends

Required qualifications

• 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
• Strong experience with Medicare Advantage and healthcare financial concepts
• Experience working with enrollment and eligibility data, including payer files such as 834/820 transactions
• Advanced Excel skills and the ability to analyze complex datasets independently