Medical Economics Analyst

October 14

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NJM Insurance Group

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Auto Insurance • Workers'​ Compensation Insurance • Homeowners Insurance • Commercial Auto Insurance • Renters Insurance

1001 - 5000

Description

• Responsible for financial reporting and analytical activities that support Healthcare Management's P&L evaluation. • Develop a detailed understanding of revenue and medical cost composition. • Analyze variance factors between Actual results and Budget. • Responsibility within Value Based Program analytics and HCM Monthly Operating Review (MOR). • Provide analysis to inform strategic focus for network and medical cost management strategies. • Develop and monitor metrics and reports related to medical cost performance. • Work closely with the Value Based Program team for financial integrity and calculations. • Coordinate and consolidate the HCM Monthly Operating Review (MOR). • Provide support to Value Based Program analytics initiatives through data mining and financial modeling. • Evaluate feasibility of strategic initiatives and support in developing financial program scenarios.

Requirements

• High School Diploma/GED required. • Bachelor degree in accounting or finance preferred or relevant experience in lieu of degree. • Requires a minimum of 3-5 years of experience in health care/managed care with direct responsibility within a Financial Planning & Analysis (FP&A) and/or Medical Cost Management & Analysis discipline. • Requires a progressive understanding of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, product pricing, network and provider contracting, and utilization management. • Experience working closely with business partners such as Analytics, Actuaries and/or FP&A in order to develop solid skillsets with medical cost analysis, market segment premium development, monthly financial reporting and variance analysis, annual business plan/budget development and presentations to management. • Requires solid understanding of P&L management principals, actual versus budget variance analysis, and general knowledge of budgeting and planning principals. • Requires general knowledge of the components underneath medical cost and utilization trends, as well as how to appropriately presents year-over-year comparisons to specifically identify variances/changes to budget and prior year. • Requires knowledge of Commercial and Medicare market sectors and products. • Requires knowledge of healthcare/managed care industry operations and products and how they relate to key metrics within financial statements.

Benefits

• Comprehensive health benefits (Medical/Dental/Vision) • Retirement Plans • Generous PTO • Incentive Plans • Wellness Programs • Paid Volunteer Time Off • Tuition Reimbursement