Sr. Medical Economic Analyst

Carilion Clinic; Roanoke (VA); On-site; USD 77,000 - 115,000; Full time

Benefits offered by this job

Medical, Dental, Vision Benefits

Pension Plan

Paid Time Off

Onsite fitness and wellness

Health app access

Childcare discounts

Continued education and training

Job summary

Carilion Clinic is seeking a Senior Medical Economist Analyst to drive payer analytics, contract modeling, and reporting for strategic initiatives. You will lead analyses that support negotiations and performance monitoring, using FinThrive and Experian MPV systems.

The role requires a Bachelor’s degree with 4+ years of data analysis experience, strong statistical skills, and the ability to communicate insights to executives. Remote/hybrid options available with onsite preference.

Qualifications

• Bachelor’s degree or 4+ years of related experience in data analysis.
• 4+ years of complex data analysis and data manipulation experience.
• Proficiency with relational databases and analytical/statistical software.
• Ability to manage deadlines while handling large data volumes.

Responsibilities

• Lead modeling of commercial and government payment methodologies across services.
• Transform data into analytical insights for Contracting and executives.
• Communicate analysis clearly for department and leadership.
• Demonstrate knowledge of payer types for contract proposals and terms.
• Leverage FinThrive and Experian MPV for enhanced analytics.
• Continuously learn to adapt to changing reimbursement environments.
• Execute complex financial and operational analyses and contract modeling.
• Extract and synthesize data to identify risks and opportunities.

Skills

Relational databases

Statistical analysis

Analytical reasoning

Problem solving

Written and verbal communication

Education

Bachelor’s degree in data science / statistics / computer science / accounting / business

Tools

FinThrive

Experian MPV

Job description

Employment Status:

Full time

Shift:

Day (United States of America)

Facility:

213 S Jefferson St - Roanoke

Requisition Number:

R162229 Sr. Medical Economic Analyst (Open)

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, stoploss 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:

$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.

Recruiter:

MARK MISKOVIC

Recruiter Email:

[e-mail]

For more information, contact the HR Service Center at 1-800-599-2537.

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-beingat 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