Senior Health Care Economics Analyst

2 days ago

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Lumeris

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Value-Based Care • Physician Engagement • Care Delivery • Accountable Care Models • Healthcare

1001 - 5000

Description

• Provides support and consultation to the organization through analyzing key business issues related to cost, utilization and revenue for multiple products. • Designs and develops reports to monitor financial performance and identify the root causes of medical cost trends. • With those root causes identified, drives innovation by creating tools to monitor trend drivers and provide recommendations to senior leaders and clients for affordability opportunities. • Extract and compile information from various systems to support decision-making. • Mine and manage information from large data sources. • Analyze claims and other data sources to identify early signs of trends or other issues related to medical care costs. • Work with clinical and market leaders to bring supplemental context/insight to data analyses, and design and perform studies related to the quantification of medical interventions. • Work with business owners to track key performance indicators of medical interventions. • Perform pro forma sensitivity analyses to estimate the expected financial value of proposed medical cost improvement initiatives. • Proactively identify and investigate complex suspect areas regarding medical cost issues, initiate in-depth analysis of the suspect/problem areas, and suggest a corrective action plan. • Draw actionable conclusions based on analyses performed, make recommendations through use of healthcare analytics, predictive modeling, and communicate those conclusions effectively to audiences at various levels of the enterprise and to clients. • Analyze the financial performance, identify favorable and unfavorable trends, develop recommendations to improve trends, communicate recommendations to leadership. • Lead projects to completion by contributing to ad-hoc data analyses, development, and presentation of findings. • Serve as subject matter expert on developing financial models to evaluate the impact of provider reimbursement changes. • Support Clinical Operations by assisting with Return on Investment (ROI) analyses for vendors to determine if their financial and clinical performance is achieving desired results. • Keep abreast of healthcare industry reforms and their impact on the organization.

Requirements

• Bachelor's degree in related field or equivalent (e.g. statistics, mathematics, economics, and actuarial science) • 8+ years of relevant experience or the knowledge, skills, and abilities to succeed • Analytical work experience within the healthcare industry (i.e., hospitals, network, ancillary, medical facilities, healthcare vendor, commercial health insurance company, large physician practices, managed care organization, etc.) • Proficiency with Microsoft Excel (formulas, PIVOT tables, PowerQuery, etc.) and MS SQL for retrieving specified information from data sources. • Experience with building dashboards in Excel, Power BI, and/or Tableau or other data visualization tools • Ability to work independently, without supervision • Preferred Experience with Medicare Advantage and ACO products

Benefits

• Medical • Vision • Dental • Well-being programs • 401(k) with company matching • Life insurance • Paid time off including paid leave • And so much more.