Medical Economics Analyst

Remote; San Francisco (CA); Remote; USD 110,000 - 150,000; Full time

Benefits offered by this job

Remote work within the United States

Full-time employment

Flexible work environment

Job summary

This remote Medical Economics Analyst position is listed on behalf of a partner company. You will analyze medical costs, trends, and financial performance to identify opportunities for efficiency and cost management within healthcare and value-based care programs.

Based in the United States, you will develop statistical models, reporting tools, and actionable insights for cross-functional teams, supporting reimbursement strategies and risk management across insurers and providers.

Qualifications

• Bachelor's degree in Mathematics, Actuarial Science, Business, Finance, or related field.
• 3+ years in healthcare industry (health insurance, value-based care, or healthcare administration).
• 2+ years analyzing healthcare claims and eligibility data, including cost and trend analysis.
• 2+ years analyzing capitated and fee-for-service provider contracts across Medicare, MA, Commercial, and Medicaid.
• 2+ years with SQL Server, DB2, or SAS.
• Strong SQL and healthcare data analytics; experience with Power BI or similar tools.
• Advanced Excel skills; familiarity with Word/PowerPoint/Access.
• Knowledge of statistical methods and provider reimbursement; actuarial analysis advantageous.
• Strong analytical thinking, problem-solving, project management, business acumen.
• Excellent communication and presentation skills; ability to explain stats to non-technical audiences.
• Self-directed, able to manage priorities and deadlines.

Responsibilities

• Lead or contribute to medical economics projects including cost savings, trend analysis, risk assessments, and deliverables.
• Develop and validate statistical models, algorithms, and reporting tools for internal and external stakeholders.
• Conduct medical cost trend analyses and forecast contractual terms for insurers and providers.
• Identify cost management opportunities and recommend data collection methods and metrics.
• Design and conduct analyses ensuring data accuracy and relevance.
• Prepare analytical reports and presentations translating findings into actionable recommendations.
• Collaborate with cross-functional teams to support performance and targets.
• Manage project commitments and ensure quality and timely outputs.
• Investigate technical details and manage tasks independently.

Skills

SQL

Healthcare analytics

Excel

Power BI

Statistical analysis

Data modeling

Communication skills

Problem solving

Project management

Actuarial analysis

Education

Bachelor's degree

Tools

SQL Server

DB2

SAS

Power BI

Job description

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Medical Economics Analyst based in the United States.

In this remote position, you will play a key role in driving data-informed decisions across healthcare and value-based care initiatives. You will analyze medical costs, healthcare trends, and financial performance to identify opportunities for improved efficiency and cost management. Working with complex healthcare claims, eligibility data, and provider contracts, you will develop statistical models, analytical tools, and actionable reports. You will collaborate with cross-functional teams and provide insights that support strategic business objectives. Your work will help healthcare organizations better understand financial performance, manage risk, and optimize reimbursement strategies. This role offers the opportunity to apply advanced analytical expertise in a collaborative, results-oriented environment with a meaningful impact on healthcare delivery.

Accountabilities:

• Lead or contribute to complex medical economics projects, including medical cost savings initiatives, trend analysis, risk assessments, and the identification of key deliverables.

• Develop, validate, and implement statistical models, algorithms, and reporting tools to address business and research questions for internal and external stakeholders.

• Conduct medical cost trend analyses, investigate variances against expectations, and support the forecasting of contractual terms for health insurers and risk-bearing healthcare providers.

• Identify opportunities for cost management and recommend appropriate data collection methods, performance metrics, and evaluation approaches.

• Design and conduct sophisticated analyses, ensuring data accuracy, integrity, and relevance to project objectives.

• Prepare analytical reports, studies, and presentations that translate complex findings into clear, actionable recommendations for management and value-based care teams.

• Collaborate with cross-functional stakeholders to support operational performance, achieve business targets, and drive effective decision-making.

• Manage project commitments, ensuring the quality, accuracy, and timely delivery of analytical outputs.

• Investigate technical details, independently manage analytical assignments, and perform additional responsibilities as required.

Requirements:

• Bachelor's degree preferred, ideally in Mathematics, Actuarial Science, Business, Finance, or a related discipline.

• At least 3 years of experience in the healthcare industry, particularly in health insurance, value-based care, or healthcare administration.

• At least 2 years of experience analyzing healthcare claims and eligibility data, including medical cost and trend analysis, variance analysis, cost management opportunities, medical economics reporting, statistical analysis, and data modeling.

• At least 2 years of experience analyzing capitated and fee-for-service provider contracts across Medicare, Medicare Advantage, Commercial, and Medicaid plans.

• At least 2 years of experience working with database management systems such as SQL Server, DB2, or SAS.

• Strong proficiency in SQL and healthcare data analytics, along with experience using reporting and visualization tools such as Power BI or equivalent platforms.

• Advanced Microsoft Excel skills and working knowledge of Word, PowerPoint, and Access.

• Knowledge of statistical analysis methods, healthcare cost drivers, and provider reimbursement methodologies. Experience with actuarial analysis and methodologies is an advantage.

• Strong analytical thinking, problem-solving, project management, and business acumen, with the ability to translate complex data into meaningful business insights.

• Excellent communication and presentation skills, including the ability to explain statistical concepts and technical findings to non-technical audiences.

• Ability to work independently, manage competing priorities, meet deadlines, and make sound recommendations that support business performance.

• A proactive, detail-oriented, and adaptable approach, with the willingness to investigate technical challenges and collaborate across teams.

Benefits:

• Remote work opportunity within the United States.

• Full-time employment.

• Flexible work environment, with the option to work remote or in a standard office setting.

• Opportunities to contribute to meaningful healthcare analytics and value-based care initiatives.

• Exposure to complex medical economics projects, healthcare financial analysis, and cross-functional collaboration.

• Some travel may be required.

• Salary, healthcare coverage, paid time off, and additional benefits have not been specified in the available job description.