Medical Economics - Analyst, Medical Economics

ArchWell Health • Nashville, TN

6d

About The Position

The Analyst, Medical Economics supports analytical needs across ArchWell Health’s Operations, Clinical, and Finance teams, focusing on markets across the Florida, East, and West regions. The role helps internal leaders understand trends, cost drivers, and financial performance using various data sources. It is a fast-paced position that offers opportunities for personal development and growth.

The analyst examines claims, membership, and admission, discharge, and transfer (ADT) data; identifies medical cost trends and drivers; develops benchmarks and monitors key performance indicators; and presents results in a clear, actionable manner. The role also builds relationships with market leaders and takes on other duties and special projects as needed.

Requirements

• Bachelor's degree in a STEM field, such as Applied Math, Statistics, Actuarial Science, Economics, or a related field.
• 1–2 years of prior analyst experience with a health plan, ACO, RBE, or consulting firm focused on healthcare analytics, decision support, or medical economics.
• Proficiency in Microsoft Excel, including formulas, PivotTables, Power BI, graphing, and other reporting and presentation features.
• Proactive initiative in exploring and discovering opportunities to improve company performance through data analysis.
• Ability to establish trusting, professional relationships with colleagues.
• Strong organization skills and ability to work in a fast-paced, team-oriented environment.
• Financial and business acumen, problem-solving and analytical skills, and keen attention to detail and accuracy.
• Knowledge of healthcare and medical economics data, including hospital, physician, and ASC claims; utilization data; and healthcare coding systems such as ICD-10, CPT/HCPCS, Revenue Codes, MS/APR-DRGs, and APCs.
• Excellent verbal, written, and presentation communication skills, including use of Microsoft Word, PowerPoint, and Excel.

Nice To Haves

• Experience in data mining and working with healthcare claims and enrollment data in large repositories and/or relational databases.
• SQL experience is strongly preferred.

Responsibilities

• Analyze claims, membership, and ADT data to identify early signs of trends or issues related to medical care costs.
• Perform qualitative analysis to identify utilization- and rate-related cost drivers, solve business problems, and improve data-driven strategies and processes.
• Partner with finance and business leaders to create benchmarks for monitoring medical cost trends and variances.
• Track medical cost key performance indicators (KPIs) for markets.
• Build trusting relationships with market leaders to support awareness of medical cost issues and challenges.
• Organize and visually present analytical results to tell a meaningful, actionable story.
• Execute other duties and special projects as needed, with a focus on knowledge and skills development.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level