Sr. Medical Economic Analyst

CP07 Carilion Services Inc; Roanoke (VA); Hybrid; USD 77,000 - 115,000; Full time

Benefits offered by this job

Comprehensive Medical, Dental & Vision

Paid Time Off

Onsite fitness & wellness benefits

Job summary

Carilion Clinic in Roanoke, VA seeks a Senior Medical Economist Analyst to lead payer analytics, payment modeling, and reporting in support of contracting and performance monitoring. The role requires transforming data into actionable insights for executive leadership and collaborators.

The position supports onsite, with hybrid or remote work options. Requires a bachelor’s degree and at least 4 years of complex data analysis experience.

Qualifications

• Bachelor’s degree in computer science, accounting, business, data science, statistics, or related field.
• 4 years of relevant data analysis and manipulation experience.
• High proficiency with computers, operating systems, relational databases, and analytical/statistical software.
• Strong analytical reasoning, problem solving, and written/verbal communication skills.

Responsibilities

• Lead payer analytics, payment modeling and reporting to support contract negotiations and performance monitoring.
• Model commercial and government payment methodologies for healthcare services (hospital, physician, ambulatory, etc.).
• Extract, analyze, and synthesize data from diverse sources to identify risks and opportunities.

Skills

Relational databases

Statistical software

Analytical reasoning

Problem solving

Written communication

Education

Bachelor’s degree in computer science, accounting, business, data science, statistics, or related field

Job description

Sr. Medical Economic Analyst (Open)

Employment Status: Full time Shift: Day (United States of America) Facility: 213 S Jefferson St - Roanoke Requisition Number: R162229

How You'll Help Transform Healthcare:

The Senior Medical Economist Analyst works closely with the Strategic Payment Relationships leadership to capture, integrate, transform, interpret and present healthcare data, in support of the best possible decision making and outcomes on a variety of strategic initiatives. They will lead payer analytics, payment modeling and reporting, in support of successful contract negotiations and payer performance monitoring. Onsite is preferred, hybrid or remote work option is available. Candidates residing in the following states can be considered for remote work: Alabama, Florida, Georgia, Arkansas, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, West Virginia, and Virginia.

Leads modeling of commercial and government payment methodologies for all types of healthcare services: hospital, physician, ambulatory, home health, hospice, etc. Transforms data into analytical insights, to inform decisions for the Contracting team and Carilion executive stakeholders. Effectively communicates analysis to be consumed by department and executive leadership. Demonstrates expert knowledge of both commercial and governmental payers for modeling and analyzing contract proposals with a variety of reimbursement methodologies: case rates, DRG, fee schedules, stop loss and other contract terms. Leverages hospital (FinThrive) and physician (Experian MPV) claim modeling systems for enhanced payer contract analytics. Continuously learns and adapts to a constantly changing reimbursement environment. Completes extensive and complex financial and operational analyses, modeling of managed care contracts and proposals, analyze fee schedules, and determine contract performance and compliance. Extracts, analyzes, and synthesizes data from various sources to identify risks and opportunities.

What We Require:

Education: Bachelor’s degree in computer science, accounting, business, data science, statistics, or related field. 4 years of relevant experience may be considered in lieu of degree.

Experience: Minimum 4 years of complex data analysis and data manipulation experience.

Licensure, Certification, and/or Registration: Specific certification(s) may be required as determined by the department. Life Support: N/A

Other Minimum Qualifications: High proficiency with computers, operating systems, relational databases, and analytical and statistical software. Demonstrated skills in research design, statistical analysis, and statistical process control methodology. Strong analytical reasoning, problem-solving capability, written and verbal communication skills. Ability to manage competing deadlines, prioritize tasks, and maintain accuracy while working with large volumes of data. Ability to handle confidential and sensitive information with discretion; occasional travel may be required.

This job description is intended to be a representative summary of the major responsibilities and accountabilities performed by incumbents in this role. Incumbents may be required to perform job-related tasks other than those specifically presented in this description.

Compensation Range:

Compensation Range: $76,689.60 - $115,044.80. Employee pay is based on a variety of factors, including qualifications, credentials, education, and prior work experience. The compensation range does not include benefits or pension plan.

Carilion Clinic is an Equal Opportunity Employer: We provide equal employment opportunities to all employees and applicants without regard to race, color, religion, sex, national origin, age (40 or older), disability, genetic information, or veterans status. Carilion is a Drug-Free Workplace. For more information or for individuals with disabilities needing special assistance with our online application process contact Carilion HR Service Center at 800-599-2537, 8:00 a.m. to 4:30 p.m., Monday through Friday. For more information on E-Verify: https://www.carilionclinic.org/eoe-e-verify-and-right-work-policies

Benefits, Pay and Well-being at Carilion Clinic

Carilion understands the importance of prioritizing your well-being to help you develop and thrive. That's why we offer a well-rounded benefits package, and many perks and well-being resources to help you live a happy, healthy life - at work and when you're away. When you make your tomorrow with us, we'll enhance your potential to realize the best in yourself.

Below are benefits available to you when you join Carilion:

• Comprehensive Medical, Dental, & Vision Benefits
• Employer Funded Pension Plan, vested after five years (Voluntary 403B)
• Paid Time Off (accrued from day one)
• Onsite fitness studios and discounts to our Carilion Wellness centers
• Access to our health and wellness app, Personify Health Discounts on childcare
• Continued education and training

In our workplace, we're devoted to the success of our employees. No matter where you are in your career, we will help you continue to learn, grow, and share your knowledge with others. Introduce yourself to our recruiters and we'll get in touch if there's a role that seems like a good match. Join an organization where innovation happens, collaboration is expected and ideas are valued. A not-for-profit, mission-driven health system built on progress and partnerships. A courageous team that is always learning, fully dedicated, and forever curious. Headquartered in Roanoke, Va., you will find a robust system of award winning hospitals, Level 1 and 3 trauma centers, Level 3 NICU, Institute of Orthopedics and Neurosciences, and multi-specialty physician practices spanning southwestern Virginia. Join us and begin your career in a place where every day is a new adventure of creating the future of health care.