Remote Medical Economics Analyst

Healthcare Outcomes Performance Company; United States; À distance; USD 90 000 - 120 000; Plein temps

Résumé du poste

Healthcare Outcomes Performance Company seeks a skilled data professional to lead and participate in complex medical economic projects, applying statistics to develop models and reporting tools for internal and external clients.

You will provide cost trend analytics, assess variances, forecast terms for health insurer and risk-bearing providers, and present findings to management. Collaboration across VBC teams and strong data integrity are essential to drive business decisions.

Qualifications

• Bachelors degree preferred in math/actuarial, business, finance, or related field.

Responsabilités

• Lead or participate in complex medical economic projects.
• 1
• 2

Connaissances

Statistical analysis

Healthcare data analytics

Project management

Data modeling

SQL

Power BI

Excel

Data quality assessment

Formation

Bachelor's degree preferred

Math/Actuarial/Business/Finance degree preferred

Outils

SQL Server

DB2

SAS

Power BI

Description du poste

ESSENTIAL FUNCTIONS

Leads or participates in complex medical economic projects (e.g., medical cost savings, trend, and risk assessment
initiatives) including identification and completion of key deliverables.
Apply statistical analysis methods to develop, validate, and execute algorithms, statistical models, and reporting tools that
answer applied research and business questions for internal and external clients.
Provide medical cost trend analytics, assess variance to expectations, and determine forecasted contract terms for health
insurer and risk bearing provider clients.
Makes recommendations about data collection methods, metrics definition, and evaluation methods.
Develops studies, analyses, and presentation materials needed to appropriately inform decision makers. Presents results
and recommendations to management across VBC teams.
Works cross-functionally throughout the organization toward achieving operational targets.
Presents complex information in a way that multiple levels within an organization can understand and utilize to make
appropriate decisions to meet business objectives.
Responsible for project commitments to quality and on-time deliverables.
Willingness to understand and probe into technical details.
Creates and evaluates the data needs of assigned projects and assures the integrity of the data.
Works independently to plan and conduct sophisticated analyses.
Other duties as assigned.

EDUCATION

Bachelors degree preferred. Undergraduate degree in math/actuarial, business, finance, or related field preferred

EXPERIENCE

Healthcare Industry Experience:
3+ years in health insurance, value-based care, or healthcare administration

Data & Analytical Expertise:
2+ years of experience analyzing healthcare claims and eligibility data, including:

• Medical cost, trend, and variance analysis. Identification of cost management opportunities. Medical economics analysis and reporting. Statistical analysis and data modeling

Contract & Product Knowledge:
2+ years of experience analyzing capitated and fee-for-service provider contracts across:

• Medicare
• Medicare Advantage
• Commercial
• Medicaid plans

Technical Skills

2+ years working with database management systems (e.g., SQL Server, DB2, SAS)
Proficiency in SQL and healthcare data analytics
Experience with reporting tools such as Power BI (or similar)
Advanced skills in Microsoft Excel; working knowledge of Word, PowerPoint, and Access

Preferred

Experience with actuarial analysis and methodologies

ABILITIES

Proficiency in statistical methods of data analysis
Understanding of medical cost drivers and provider reimbursement methodologies
Strong problem solving, analytical, and project management skills
Demonstrated extensive and diverse knowledge of health care data, metrics, systems, and standards; demonstrated subject matter expert in multiple subject areas
Ability to make sound decisions and recommendations to drive business solutions
Ability to communicate statistical and technical ideas and results to non-technical clients
Ability to work independently and complete projects within established timeframes
Self-starter and ability to juggle competing priorities

SKILLS

General business/demonstrated business and industry acumen
General business/turning data into information
Finance/delivering profit and performance

ENVIRONMENTAL WORKING CONDITIONS

Normal office environment or remote
Some travel

PHYSICAL/MENTAL DEMANDS

Requires sitting and standing associated with a normal office environment.
Some bending and stretching are required.
Manual dexterity using a computer keyboard, phone, and scanner.

ORGANIZATIONAL REQUIREMENT

HOPCo Mission, Vision, and Values must be read and signed.
This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills,
abilities, and working conditions may change as needs evolve.