Advisor, Medical Economics

Job Overview

JOB DETAILS

REQUIREMENTS

• Bachelor’s degree in Applied Math, Statistics, Actuarial Science, Economics, or a related field required
• 4+ years of prior experience as an analyst with a health plan, ACO, RBE, or consulting firm focused on health economics
• Expertise in MS Excel, including proficiency using formulas, PivotTables, PowerBI, graphing and other reporting and presentation features
• Experience working with internal groups, including IT, to procure necessary datasets preferred
• Experience in data mining working with large data repositories and/or relational databases with SQL experience strongly preferred
• Experience creating product trend analyses using statistically valid methodologies

RESPONSIBILITIES

• Identify, monitor, and analyze principal health care cost drivers, by market segment and/or by provider, including utilization and referral patterns and reimbursement rates
• Research healthcare delivery topics, analyze data, present results, and recommend solutions to address business challenges by applying knowledge of medical claims analysis, critical-thinking skills, and healthcare experience/expertise
• Analyze claims, membership, and prior authorization data to identify early signs of trends or other issues related to medical care costs and quality of care
• Provides actuarial support for Medicare Advantage plans by identifying trends and profitability drivers utilizing sound statistical methods.
• Utilizes experience with HCCs and RAFs to forecast revenue projections
• Structure analytical results in an organized, visual manner to tell a meaningful, actionable story
• Work with Engineering team to source data, determine its credibility and usability, create end-user reports, and apply varying analytical techniques to solve specific business problems
• Perform ad-hoc requests from key stakeholders
• Interpret contractual language with a clear understanding of business rules and reporting requirements
• Execute other duties and special projects as needed, focusing on knowledge and skills development

Are you interested in this position?

Apply by clicking on the “Apply Now” button below!

#CrossChannelJobs#JobSearch
#CareerOpportunities#HiringNow
#Employment#JobOpenings
#JobSeekers
FacebookLinkedIn