Medical Economics Consultant (Pop Health/Clinical Analytics) - REMOTE

Molina Healthcare; Dallas (TX); Remote; USD 80,000 - 135,000; Full time

Job summary

A healthcare consulting company is looking for a Medical Economics Consultant to provide analytical support and insights related to medical costs and network initiatives. This role requires a Bachelor's degree in Finance, Mathematics, Statistics, or Economics and 5-7 years of relevant experience in the healthcare sector. The Consultant will analyze data to help improve company strategies and management decisions, with a base pay range of $80,412 - $135,000 annually.

Benefits

Competitive benefits and compensation package

Equal Opportunity Employer

Qualifications

• 5 - 7 years of experience in healthcare or managed care industry.
• Knowledge of provider contracting and reimbursement.
• Experience with medical and pharmacy claims preferred.

Responsibilities

• Provide consultative support and medical cost-based analysis.
• Extract and analyze data to identify risks and opportunities.
• Consult with management on improving discount positions.

Skills

Data visualization

Utilization analysis

Cost driver research

Project management

Excel skills

Data mining

Education

Bachelor's Degree in Finance, Mathematics, Statistics, or Economics

Tools

Excel

MS-Access

Web-based query tools

Job description

Overview

Provides consultative support and medical cost-based analysis of markets and network initiatives. The Medical Economics Consultant manages conflicting priorities and multiple projects concurrently. Responsible for extracting, analyzing, and synthesizing data from various sources to identify risks and opportunities as well as packaging and delivering the results to senior leadership. Responsible for consulting with network and clinical management on opportunities to improve our company’s discount position and strategic cost and utilization initiatives.

Knowledge/Skills/Abilities

• Analyze and research utilization and unit cost medical cost drivers
• Turn data into usable information by telling the story through data visualization, working with clinical, provider network and other personnel to bring supplemental context and insight to data analyses
• Support the development of scoreable action items by identifying outlier cost issues
• Perform drill-down analysis to identify medical cost trend drivers; advise network of contracting opportunities to mitigate future trends
• Own, track and document all aspects of related work from beginning to end of a project
• Extract and compile information from various systems to support executive decision-making
• Ability to mine and manage information from large data sources
• Working with Excel, MS-Access and Web-based query tools (data warehouse)

Job Qualifications

REQUIRED EDUCATION:

Bachelor's Degree in Finance, Mathematics, Statistics, or Economics

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:

5 - 7 years in healthcare/managed care industry with knowledge of provider contracting, provider reimbursement, patient management, product, benefits design, or related experience.

PREFERRED EDUCATION:

Master’s Degree in Business Administration, Finance, Mathematics, Statistics, or Economics

PREFERRED EXPERIENCE:

Experience working with medical and pharmacy claims, authorization data, benefits design, medical management as well as knowledge of business functions and impact on financials (underwriting, sales, product development, network management.)

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $80,412 - $135,000 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.