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

Molina Healthcare; Macon (GA); Remote; USD 80,000 - 135,000; Full time

Job summary

A healthcare organization based in Macon, Georgia, is seeking a Medical Economics Consultant to analyze and provide insights on medical costs. The ideal candidate will have a Bachelor's degree in relevant fields, 5-7 years of experience in the healthcare industry, and strong skills in data visualization and analysis. The position offers competitive compensation and opportunities for professional growth.

Qualifications

• 5-7 years in healthcare/managed care with provider contracting knowledge.
• Experience with medical and pharmacy claims.

Responsibilities

• Analyze utilization and unit cost medical cost drivers.
• Support development of scoreable action items.
• Own, track and document all project aspects.

Skills

Data visualization

Analysis of medical cost drivers

Documenting project aspects

Mining large data sources

Education

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

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

Tools

Excel

MS-Access

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.