Senior Analyst, Medical Economics

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

📋 Description

• Deliver consultative assistance and perform medical cost-based market and network initiative analyses.

• Collaborate with network and clinical management to identify opportunities for enhancing discount positions and implementing strategic cost and utilization initiatives.

• Prepare for monthly presentations as a participant in the Medical Expense Review team.

• Manage both long-term and short-term projects in partnership with local market leaders.

• Analyze and investigate utilization and unit-cost medical expense drivers.

• Transform data into actionable insights through data visualization techniques.

• Assist in the creation of scoreable action items by pinpointing outlier cost issues.

• Conduct in-depth analysis to uncover medical cost trend drivers.

• Provide guidance to the network on contracting opportunities to alleviate future trends.

• Oversee, monitor, and document all related work from the project's inception to completion.

⛳️ Requirements

• A minimum of 3 years of experience in analytics or finance, or a comparable background.

• A bachelor's degree or equivalent professional experience is mandatory.

• Prior experience in the healthcare sector is essential.

• Familiarity with managed care operations, including provider contracting, benefit design, and medical management.

• Understanding of business functions and their effects on financials, encompassing underwriting, sales, product development, and network management.

• Experience in handling medical and pharmacy claims.

• Proficiency with Excel, MS-Access, Power BI, and web-based query tools/data warehouses.

• Capability to handle conflicting priorities and manage multiple projects simultaneously.

• Availability to work 40 hours per week.

🏝️ Benefits

• Flexible work location.

• Work-life balance.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources promoting physical, emotional, and financial well-being.

• CVS Health bonus, commission, or short-term incentive program in addition to base salary.