Senior Specialist, Payer Analytics

Scipher Medicine develops innovative diagnostic tests to determine drug response and targeted therapies using its proprietary personalized medicine platform based on molecular technology. Our platform allows us to interpret genomic data to gain unique insights into disease biology so patients with even the most complex diseases can achieve optimal health outcomes.

With only about 1 out of 3 patients adequately responding to anti-tumor necrosis (anti-TNF) therapies, the world’s largest selling drug class, we developed our flagship test, PrismRA™, to predict response to these drugs, thereby ensuring patients receive the most effective therapies from day one. Scipher is transforming the traditional diagnostics business model by working closely with payers to change the way medications will be prescribed, saving both insurers and patients billions wasted in ineffective prescription costs. This is a unique opportunity to join a promising venture at an early stage to tackle some of the biggest problems in healthcare.

We are proud of our passionate, high-performance, mission-driven culture – one based on a set of values that are the cornerstone of who we are and how we hold ourselves accountable. Founded in 2015, we are based in Waltham, MA and currently expanding across all functions within the organization. We are backed by Khosla Ventures, Northpond Ventures, Alumni Ventures and Tachyon Ventures, and are well capitalized to execute our vision of launching a personalized medicine platform that transforms patients’ lives. Check us out at and follow us on LinkedIn.

The Role:

We are seeking a highly motivated, conscientious and diligent team member, who is also flexible, dynamic, and proactive. The Senior Specialist will join an integrated team structure that will provide them with exposure to health economic and market segmentation modeling research from the formulation of concepts through to model programming and dissemination of the findings. The Senior Specialist will work closely with other internal and external modeling team and data science members, and other Scipher Medicine colleagues, to develop market segmentation and economic models and conduct health economics research.

Positioned within the Market Access team, the team values, implements, and tracks initiatives aimed at producing improved patient outcomes with savings and opportunities to bend payer customer cost trends. The team is empowered with the resources it needs to produce results and deliver impactful business recommendations. As a Senior Specialist, you will map out and construct detailed analyses, confront challenging and unfamiliar subjects, and interface with stakeholders across all departments and lines of business. The conclusions you reach have the potential to improve and influence the organization, playing an essential part in our mission to provide patients with affordable and accessible high-quality care. Each day you’ll tackle new and unique questions, learning and growing as you develop strategies, find solutions, and build innovative new approaches that support our goals and drive success.

The role involves managing projects from analysis to implementation and beyond ensuring that results are achieved, and leadership is aware of the unique headwinds and tailwinds faced by any initiative. The ability to simplify complex scenarios into key takeaways is essential, as is the ability to explain and drill into any given detail behind the analyses you create. You’ll be expected to make independent decisions and support them under scrutiny. Potential areas of analysis include payment policy, utilization management, and value-based payment arrangements. The ideal candidate will be eager to learn, excited to grow, ready for a challenge, and able to thrive in a collaborative and collegial work environment.

Where: Waltham, MA.

What will I do?
– The Senior Specialist will lead the development of health economics and value-based payment models, including cost-effectiveness models and budget impact models by conducting literature reviews for studies on Randomized Controlled Trials (RCTs), Health Related Quality of Life (HRQoL), real world evidence, cost analyses, clinical guidelines, Health Technology Assessments, economic evaluations, and other health economics analyses
– Programing the models using Microsoft Excel with Visual Basic for Applications (VBA)
-Performing basic statistical analyses supporting economic and market segmentation modeling (e.g., survival analysis, analyses of utility data, analyses of market data, etc.)
-Support the preparation and presentation of internal and external communications (presentations, technical reports, conference abstracts, and manuscripts)

Minimum Education and Qualifications:
– A post-graduate degree in relevant field (i.e. Epidemiology, Biostatistics, Health Economics, Public Health or Operational Research) is preferred
– Minimum 3 years of experience in Health Economics and Outcome Research, experience in diagnostics preferred
– Analytical work experience within the healthcare industry (i.e. hospitals, network, ancillary, medical facilities, healthcare vendor, commercial health insurance company, large physician practices, managed care organization, etc.)
– Work experience with SAS and/or SQL where you have created queries, pulled large data sets and performed data manipulations/analysis
– Experience with MS Excel functions that include working with large data sets, creating standardized reports, utilizing vLookups and advanced functions/formulas; creating, using and interpreting pivot tables, filtering and formatting
– Knowledge of healthcare financial terms such as cost, utilization, Per Member Per Month (PMPM) and revenue
– Basic understanding of Medicaid and Medicare programs or other healthcare plans
– Self-motivated, creative problem solver who can work independently and collaborate through strong communication and interpersonal skills
– Strong quantitative skills with a good understanding of basic statistics
– Experience in Excel, Visual Basic or TreeAge programming for modeling is preferred
– Strong written and oral communication skills and be able to demonstrate collaboration and teaming skills while working within cross-functional international teams
– Strong project management experience and ability to handle multiple projects in a fast-paced environment
– Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG’s), Ambulatory Patient Groups (APG’s), Ambulatory Payment Classifications (APC’s), and other payment mechanisms
– Understanding of value-based risk arrangements
– Experience using Tableau

To all recruitment agencies: Scipher Medicine does not accept agency resumes. Please do not forward resumes to our jobs alias, or Scipher Medicine employees. Scipher Medicine is not responsible for any fees related to unsolicited resumes.

Scipher Medicine is proud to be an equal opportunity workplace and is an affirmative action employer. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status.  Scipher will make reasonable accommodations for qualified individuals with known disabilities, in accordance with applicable law.