Healthcare Analyst

HealthFirst•New York, NY

2d•$68,900 - $99,620•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 role identifies and monitors cost and utilization trends, investigates root causes of health plan performance, and recommends solutions. The analyst works with divisional subject matter experts, clinical partners, Finance, and other internal teams, and supports stakeholders in areas such as operations and medical management as well as external hospital and provider networks. The position contributes to a broad range of departmental projects and suits someone with emerging skills who enjoys a fast-paced, challenging environment. This role follows a hybrid schedule, with work at the 100 Church Street, New York City office every Tuesday, Wednesday, and Thursday.

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 able to work independently and collaborate using 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.
Knowledge of Medicaid and Medicare programs.
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, including 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 reports.
Support departmental projects related to medical cost reduction initiatives.
Assist with return on investment (ROI) analyses for vendors to assess whether financial and clinical performance is achieving desired results.
Keep abreast of New York Medicaid and Medicare reforms and their impact on Healthfirst and its owner hospitals.
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.
Perform contract analysis and fee schedule modeling.
Maintain current project logs and work plans for assignments.
Perform additional duties as assigned.