Senior Associate, Medical Economics

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

📋 Description

• Assist in the internal development of Hopscotch’s cost categorization capabilities, which includes customizations, updates for new code and mappings, and managing changes.

• Responsible for the continual upkeep, enhancements, governance, change control, and documentation related to Hopscotch’s payer data and cost categorization functionalities.

• Create and sustain the medical economics reporting suite (e.g., SQL, PBI, Excel) while supporting IBNR estimation, cohort forecasting, and paid-risk pacing.

• Examine monthly outputs to identify cost drivers and emerging trends, differentiating genuine movements from the effects of incomplete claims and statistical noise.

• Evaluate medical cost trends across various factors such as unit costs, utilization, and mix; enhance claims with EHR, eligibility, provider, and risk adjustment data to clarify population-level trends and financial performance.

• Collaborate with medical economics and finance leadership to pinpoint and conduct high-impact analyses, including pro forma and ROI assessments for medical cost initiatives.

• Partner with Clinical, Operations, and Finance teams to translate business inquiries into analyses, ensure accurate results flow into management reporting, and develop repeatable analytic processes that can scale across programs.

⛳️ Requirements

• Bachelor's degree in Economics, Finance, Statistics, Mathematics, Health Informatics, Actuarial Science, or a closely related quantitative field.

• Over 3 years of experience in healthcare analytics or medical economics (payer, provider, health system, ACO, or VBC).

• High level of proficiency in SQL, Power BI, and Excel.

• Practical experience with healthcare claims data and integrating various data sources (claims, eligibility, EHR, risk adjustment).

• Familiarity with healthcare financial and utilization concepts (e.g., PMPM, MLR, utilization per 1,000, trend, risk adjustment).

• Experience in enhancing data models, identifying opportunities for improvement while continuing to derive value from emerging datasets.

• Proven experience in presenting and communicating data-driven insights to functional leaders.

🏝️ Benefits

• Paid holidays + PTO

• Company sponsored medical, dental, and vision insurance for you + your family

• FREE short-term and long-term disability insurance

• FREE $100k life insurance policy

• 401k plan with 4% company match + no vesting period

• $720 - $1,000 added to employee Health Savings Account annually for eligible health plans

• And more!