Medical Economics Analyst I

Millennium Physician Group•New York, NY

About The Position

The Medical Economics Analyst supports all healthcare analytical efforts of the fast-growing company’s various value-based contracts ranging from MSSP ACOs, Medicare Advantage Plans, and Commercial ACOs. This position will use state of the art population health system, electronic health record, EDW, Tableau, Sigma, and various payer portals and reports to gather, analyze, and present actionable solutions to complex healthcare issues. This position will require strong proficiency in SQL. The analysis will range from macro healthcare cost and/or trends and individual patient analysis. The position works on multiple projects as a subject matter expert in a fast-paced environment for the support of executive management, physicians and other internal or external clients. Works closely with the company’s clinical integration, care coordinator and quality teams to provide meaningful data for clinical transformation, quality and process improvement initiatives. Obtains, understands and communicates reporting specifications from government agencies and other entities.

Requirements

Bachelor’s in Business Administration, Healthcare Administration or related field required
2+ years experience in healthcare, insurance, consulting, or data analytics; an understanding of Electronic Medical records and population management systems strongly preferred
Utilization of data analytics or visualization tools (e.g., Excel, SQL, SAS, Tableau, Statistical Modeling, Sigma, Databricks)
Ability to read, analyze, and interpret common financial reports and contracts.
Ability to respond to inquiries from internal customers.
Ability to effectively present information to management and/or end users.
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
Ability to analyze and interpret the raw data and data trends to properly communicate to the management and end users to create action oriented plans that will result in positive movement of measures.
To perform this job successfully, an individual should have advanced knowledge of Microsoft Excel software, including use of pivot tables and other advanced data manipulation techniques; Microsoft Word; Microsoft Excel; Microsoft Access; Microsoft PowerPoint, SQL Server, Snowflake, Databricks, Sigma, SSRS and Adobe Software Suite.

Nice To Haves

MBA, MPH, MHA, or advanced degree in a related area preferred
Experience in healthcare and/or value-based modeling, including Medicare Advantage, Medicare Shared Savings Program (MSSP), payor risk models, is a plus

Responsibilities

Create proactive analyses comparing company or market results to industry data to evaluate program performance for internal management and internal clients
Monitor medical expense trends, identify emerging drivers, and recommend cost containment strategies
Analyze claims data to assess performance against benchmarks, budgets, and shared savings targets
Partner with leadership, operations, FP&A, care management, quality, and clinical partnerships teams to analyze interventions that improve care efficiency and reduce avoidable costs
Develop and produce financial reports and clinical analysis on a periodic and ad-hoc basis for care coordination staff as well as physicians and executive leadership.
Ensures accuracy and timeliness of the company’s staff and physician reports to include regularly scheduled and ad-hoc reporting requests.
Responsible for all follow-up and/or research requests regarding physician data
Participates in project teams, analyzing various new programs, projects, or ventures that require analysis of clinical, financial, or utilization data
Prepares reports, presentations, and other documents and presents these materials in meetings
Identify problematic areas and conduct research to determine the best course of action to correct EDW data
Participates in high-level business initiatives and assist with all levels of metric reporting
Maintains a working knowledge of relevant Government, payor, and third-party health care initiatives in which the company participates. It is assumed, in order to maintain these skills, that relevant seminars, books, periodicals and regulations be routinely reviewed
Identify and research anomalies and outliers in data
Assist with maintaining the organizational roster process to ensure accurate attribution of patients to care teams across all payers.
Analyze performance and trends with our VB arrangements with 3rd party vendors
Create, update, and maintain Tableau Dashboards across the organization
Create, update, maintain, and distribute organizational excel reporting and provider patient list reports.
Performs other related duties as assigned or requested