Medical Economics Analyst

This is a fully remote position, open to applicants in Arizona.

📋 Description

• Lead or take part in intricate medical economic projects, focusing on medical cost savings, trend analysis, and risk assessment initiatives.

• Identify and achieve essential project deliverables.

• Utilize statistical analysis techniques to create, validate, and implement algorithms, statistical models, and reporting tools.

• Provide analytics on medical cost trends and evaluate variances against expectations.

• Establish projected contract terms for health insurers and risk-bearing provider clients.

• Suggest data collection techniques, metric definitions, and evaluation approaches.

• Develop studies, analyses, and presentation materials for decision-makers.

• Present findings and recommendations to management across Value-Based Care (VBC) teams.

• Collaborate cross-functionally to meet operational objectives.

• Convey complex information in a manner that can be utilized by various organizational levels for business decisions.

• Ensure quality and timely project deliverables.

• Explore technical details.

• Create and assess data requirements while ensuring data integrity.

• Independently plan and execute sophisticated analyses.

• Perform additional tasks as assigned.

• Operate in a standard office environment or remotely, with occasional travel required.

⛳️ Requirements

• Bachelor’s degree preferred; an undergraduate degree in mathematics/actuarial science, business, finance, or a related field is preferred.

• Over 3 years of experience in health insurance, value-based care, or healthcare administration.

• At least 2 years of experience analyzing healthcare claims and eligibility data.

• Experience with medical cost, trend, and variance analysis.

• Proven track record of identifying cost management opportunities.

• Familiarity with medical economics analysis and reporting.

• Experience in statistical analysis and data modeling.

• A minimum of 2 years analyzing capitated and fee-for-service provider contracts.

• Knowledge across Medicare, Medicare Advantage, Commercial, and Medicaid plans.

• At least 2 years of experience working with database management systems such as SQL Server, DB2, or SAS.

• Proficient in SQL and healthcare data analytics.

• Experience with reporting tools like Power BI or similar.

• Advanced skills in Microsoft Excel; working knowledge of Word, PowerPoint, and Access.

• Proficient in statistical methods for data analysis.

• Understanding of medical cost factors and provider reimbursement methodologies.

• Strong problem-solving, analytical, and project management abilities.

• Extensive and varied knowledge of healthcare data, metrics, systems, and standards.

• Capability to make sound decisions and recommendations.

• Ability to articulate statistical and technical concepts to non-technical clients.

• Competence to work independently and complete projects within established deadlines.

• Capacity to manage competing priorities effectively.

• Acknowledgment and signature of HOPCo Mission, Vision, and Values are required.

🏝️ Benefits

• Full-time employment.

• Option for remote work.

• Occasional travel required.