Medical Economics Analyst

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

📋 Description

• Assist in managing the organization's value-based contracts, including MSSP ACOs, Advantage, and Commercial ACOs.

• Conduct standard and recurring analyses to evaluate medical cost trends, utilization, risk score performance, quality metrics, and shared savings outcomes.

• Generate data pulls, ongoing reports, provider-level summaries, and fundamental performance analyses utilizing established methodologies and templates.

• Detect significant trends, discrepancies, or potential data issues, and escalate discoveries to senior team members.

• Aid in ad hoc analyses and special projects by collecting data, executing calculations, and documenting findings.

• Acquire a working knowledge of value-based program requirements, payer methodologies, benchmarks, and essential performance measures.

• Execute routine data validation, reconciliation, and quality checks to ensure the accuracy of analytical outputs.

• Assist in managing recurring datasets, extracts, and reporting activities.

• Collaborate with senior analysts or data engineering resources to identify and rectify data discrepancies.

• Create and sustain standard reports and dashboards using Tableau, Sigma, Excel, or other approved reporting tools.

• Conduct quality assurance on regular dashboards and reports prior to dissemination.

• Develop charts, tables, and summaries to convey key findings to internal stakeholders.

• Support automation initiatives and process improvement efforts.

• Work together with cross-functional internal teams on analytical inquiries.

• Participate in project and stakeholder meetings, report on progress, and ensure follow-up on action items.

• Clearly articulate analytical results tailored to the audience.

• Contribute to team standards, documentation, and the sharing of best practices.

⛳️ Requirements

• Basic understanding of healthcare claims, EHR, risk adjustment, quality, attribution, and financial data.

• Proficiency in writing, modifying, and troubleshooting SQL queries utilizing established data models, tables, and coding standards.

• Experience or capability to work with healthcare datasets, including claims, EHR, risk adjustment, quality, and attribution data.

• Competence in performing data validation, reconciliation, and quality checks.

• Ability to create and maintain reports and dashboards in Tableau, Sigma, Excel, or other authorized reporting tools.

• Skill in documenting query logic, data sources, metric definitions, assumptions, and analytical processes.

• Capability to communicate analytical findings effectively to internal stakeholders.

• Ability to collaborate with Medical Economics, Finance, Quality, Care Management, Population Health, Clinical Operations, and other internal teams.

• Openness to seek feedback, incorporate coaching, and contribute to team standards and best practices.

🏝️ Benefits

• Competitive salary and performance-based incentives.

• Comprehensive health, dental, and vision insurance plans.

• Opportunities for professional development and ongoing training.

• Flexible work hours and remote work options.

• Collaborative and inclusive work environment.