Healthcare Analyst

HF Management Services•New York, NY

23h•Hybrid

About The Position

The Healthcare Analyst (HCA) researches and investigates business issues related to cost, utilization, and revenue data across multiple Healthfirst products. The analyst identifies and monitors cost and utilization trends, investigates root causes of health plan performance, and recommends solutions. The role works with divisional subject matter experts, clinical partners, Finance, and other teams to support business objectives, projects, and performance improvement. It provides analysis and insights to internal stakeholders, including operations and medical management, as well as external hospital and provider networks. The position is intended for someone with emerging skills who enjoys a fast-paced, challenging environment. The work schedule is hybrid, with reporting to the 100 Church Street, New York City office every Tuesday, Wednesday, and Thursday. The hiring range is $68,900–$99,620 for Greater New York City Area residents (NY, NJ, CT) and $61,300–$91,120 for other approved locations. Salary and related compensation depend on work experience, education, licenses, certifications, and other factors. Healthfirst offers medical, dental, and vision coverage, incentive and recognition programs, life insurance, and 401(k) contributions, subject to eligibility requirements.

Requirements

Bachelor's degree or higher from an accredited institution, concentrated in Finance, Accounting, Business, Public Health, Healthcare Policy, or Healthcare Administration.
Self-motivated, creative problem solver who can work independently and collaborate effectively through strong communication and interpersonal skills.
Strong project management experience and ability to handle multiple projects in a fast-paced environment.
Experience analyzing medical cost and utilization trends.
Intermediate skills using MS Excel.

Nice To Haves

Current or previous work experience with a health insurance company.
Demonstrated understanding of managed care concepts and provider reimbursement principles, such as risk adjustment, capitation, fee-for-service, DRGs, APGs, APCs, and other payment mechanisms.
Skills in SAS, SQL, R, Tableau, or a similar coding language.
Experience modeling the financial impact of provider reimbursement changes.

Responsibilities

Analyze the financial performance of Healthfirst products, identify favorable and unfavorable trends, develop recommendations to improve trends, and communicate recommendations to management.
Create financial models to evaluate the impact of provider reimbursement changes.
Gather data, conduct ad hoc analyses, and assist with developing and presenting analytical data reports.
Support department projects related to medical cost reduction initiatives.
Assist with Return on Investment (RoI) analyses for vendors to assess financial and clinical performance.
Keep abreast of New York Medicaid and Medicare reforms and assess their impact on Healthfirst and owner hospital performance.
Support the department’s performance improvement work groups.
Monitor cost and revenue trends and assist in understanding them.
Understand and analyze the impacts of new program changes.
Create, modify, and update analyses for Provider Organizations.
Conduct contract analysis and fee schedule modeling.
Maintain current project logs and work plans for assignments.
Perform additional duties as assigned.