Title : Healthcare Analytics Medical Economics Manager - Medical Economics

Arizona Health Care Cost Containment System; Phoenix (AZ); Hybrid; USD 80,000 - 110,000; Full time

Job summary

Join a leading public service organization in Arizona as a team manager overseeing Healthcare Analytics and Data Governance. This role involves data analysis, team management, and strategic decision-making to improve healthcare services. Ideal candidates will have a strong background in healthcare data management and excellent communication skills. Enjoy a flexible work schedule and numerous benefits, including paid leave and retirement plans.

Benefits

Paid Holidays

Paid Vacation

Paid Sick Time

Paid Parental Leave

Retirement Benefits

Affordable Insurance Plan

Learning Opportunities

Qualifications

• 5 years of relevant work experience with Medicaid or Medicare data.
• Experience with SQL, SAS, Python, R, and data visualization tools.

Responsibilities

• Manage Healthcare Analytics and Data Governance teams.
• Oversee data-driven analysis and presentation of healthcare data.
• Lead agency initiatives and educate stakeholders on data value.

Skills

Interpersonal Skills

Problem-Solving

Communication

Education

Bachelor's degree in Mathematics

Master’s degree in Mathematics

Tools

SQL

SAS

Python

R

Cognos

PowerBI

Job description

A career in public service awaits you. COME JOIN OUR TEAM!

This position manages two teams : Healthcare Analytics Medical Economics and Data Governance.

The Healthcare Analytics Medical Economics team translates Medicaid claims, encounters, membership and other data into consumable actionable insights via summaries, visualizations and recommendations. It also enables AHCCCS to make data-driven decisions to meet the AHCCCS mission of reaching across Arizona to provide comprehensive quality health care to those in need.

The Data Governance team establishes management and governance practices over the agency’s data assets. This includes championing data management and best practices in the agency and representing AHCCCS at the State Data Management Steering Committee.

Major duties and responsibilities include but are not limited to :

• Oversight of Healthcare Analytics Medical Economics Team, data-driven analysis and its presentation : Working with business areas to create and monitor standard reporting packages and dashboards including key performance indicators, Researching healthcare delivery topics, analyze data, and recommend solutions to address business challenges by applying knowledge of medical claims analysis, critical-thinking skills, and healthcare experience and expertise, Analyze claims, encounters, membership, and other data to identify early signs of trends or other issues related to medical care costs and quality of care, Present the results of analysis to Agency leaders and peers.
• Oversight of Data Governance Team and process : Coordination of data stewardship, Responsible for agency data related documentation, Representing AHCCCS at the State Data Management Steering Committee, Ensuring that statewide policies are implemented and followed.
• Manage, coach and mentor team members. Support the intake, prioritization and coordinated execution of ad-hoc analytics and data governance requests from departments across the organization.
• Lead Agency initiatives, supporting staffing to deliver results across all functions within the Healthcare Analytics Medical Economics and Data Governance teams including : Develop research and analyze processes to review financial data to draw conclusions for senior leadership.
• Lead efforts to educate executives, employees and customers regarding the strategic value of data and its important role as a business asset and a decision-making tool. Collaborate with line of business data owners to assess, prioritize and mitigate risks that may affect business operations and regulatory compliance resulting from data quality issues.
• Establish and monitor data quality efforts and provide a central leadership for the resolution of data issues. Develop methods to monitor program or area progress and take corrective actions when necessary.
• Manage and monitor multiple projects simultaneously establishing project plans and objectives to ensure goal attainment within defined parameters.
• Support the development and training of team members and colleagues.

Knowledge :

• Data management concepts, practices, and procedures focusing on data governance
• Healthcare data and concepts including medical and pharmacy claims, utilization management and demographic data and healthcare industry coding systems ICD-10, CPT / HCPCS, Revenue Codes, and others as applicable
• Modeling of complex datasets
• Data analysis and data mining
• Reporting and analytics
• IBM Cognos, Power BI and / or equivalent BI tools
• Microsoft Excel, Word and PowerPoint
• Medicaid / Medicare programs and services
• PMMIS
• AHCCCS business needs, operations and dependencies
• Encounter processing

Skills :

• Excellent interpersonal, written & oral communication skills (verbal, written, and presentation)
• Excellent problem-solving skills & attention to details
• Managed Care Organization and CMS policy that relate to data governance

Abilities :

• Balance, prioritize and organize multiple tasks
• Work collaboratively in teams and across organizations
• Synthesize feedback and adjust plans accordingly
• Build strong relationships inside and outside the organization
• Resolve incidents / problems efficiently and effectively, recognizing customers’ competence levels, and able to approach each level appropriately
• Supervise small to medium teams
• Understand and anticipate needs and priorities of both internal and external customers
• Organize and present data in a way that facilitates inferences, conclusions and decisions

Qualifications : Minimum :

• Bachelor's degree in Mathematics, Statistics, Economics or related field plus 5 years of relevant, professional work experience (or equivalent experience). Medicaid or Medicare experience working with healthcare data including but not limited to medical claims data at a medical insurance company or equivalent at a State or Federal level for these programs. Experience querying, summarizing, and manipulating data using SQL, SAS, Python, R, Machine Learning, Cognos or PowerBI.

Preferred :

• Master’s degree in Mathematics, Statistics, Economics, or healthcare related discipline. Experience preparing / presenting dashboards and data using a data visualization tool such as PowerBI. Experience clearly explaining complex methodologies and present findings and recommendations to both technical and non-technical audiences.

Pre-Employment Requirements :

• Successfully pass fingerprint background check, prior employment verifications and reference checks; employment is contingent upon completion of the above-mentioned process and the agency’s ability to reasonably accommodate any restrictions.
• Travel may be required for State business. Employees who drive on state business must complete any required driver training (see Arizona Administrative Code R2-10-207.12.)

If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, then the following requirements apply : Driver’s License Requirements.

All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).

Benefits :

Among the many benefits of a career with the State of Arizona, there are :

• 10 paid holidays per year
• Paid Vacation and Sick time off (13 and 12 days per year respectively) - start earning it your 1st day (prorated for part-time employees)
• Paid Parental Leave-Up to 12 weeks per year paid leave for newborn or newly-placed foster / adopted child. Learn more about the Paid Parental Leave pilot program here.
• Other Leaves - Bereavement, civic duty, and military.
• A top-ranked retirement program with lifetime pension benefits
• A robust and affordable insurance plan, including medical, dental, life, and disability insurance
• Participation eligibility in the Public Service Loan Forgiveness Program (must meet qualifications)
• RideShare and Public Transit Subsidy
• A variety of learning and career development opportunities

By providing the option of a full-time or part-time remote work schedule, employees enjoy improved work / life balance, report higher job satisfaction, and are more productive. Remote work is a management option and not an employee entitlement or right. An agency may terminate a remote work agreement at its discretion.

Learn more about the Paid Parental Leave pilot programhere.