Remote Medical Economics Analyst

Healthcare Outcomes Performance Co. (HOPCo)•Phoenix, AZ

About The Position

The Medical Economics Analyst leads or participates in complex medical economics projects, including medical cost savings, trend, and risk assessment initiatives. The role applies statistical analysis to develop, validate, and execute algorithms, models, and reporting tools that address applied research and business questions for internal and external clients. It provides medical cost trend analytics, assesses variance to expectations, and determines forecasted contract terms for health insurer and risk-bearing provider clients. The analyst recommends data collection methods, metric definitions, and evaluation methods; develops studies, analyses, and presentations to inform decision makers; and presents results and recommendations to management across value-based care teams. The role works cross-functionally toward operational targets and communicates complex information so people at multiple organizational levels can use it to make business decisions. It is responsible for high-quality, timely project deliverables, evaluating project data needs and data integrity, and independently planning and conducting sophisticated analyses. Other duties may be assigned. The work environment may be a normal office or remote setting, with some travel. The position requires sitting and standing in a normal office environment, some bending and stretching, and manual dexterity when using a computer keyboard, phone, and scanner. The employee must read and sign HOPCo’s Mission, Vision, and Values. Responsibilities and working conditions may change as organizational needs evolve.

Requirements

At least 3 years of experience in health insurance, value-based care, or healthcare administration.
At least 2 years of experience analyzing healthcare claims and eligibility data, including medical cost, trend, and variance analysis; identifying cost management opportunities; medical economics analysis and reporting; and statistical analysis and data modeling.
At least 2 years of experience analyzing capitated and fee-for-service provider contracts across Medicare, Medicare Advantage, Commercial, and Medicaid plans.
At least 2 years of experience working with database management systems such as SQL Server, DB2, or SAS.
Proficiency in SQL and healthcare data analytics.
Experience with reporting tools such as Power BI or similar.
Advanced Microsoft Excel skills and working knowledge of Word, PowerPoint, and Access.
Proficiency in statistical methods of data analysis.
Understanding of medical cost drivers and provider reimbursement methodologies.
Strong problem-solving, analytical, and project management skills.
Extensive and diverse knowledge of healthcare data, metrics, systems, and standards, with subject-matter expertise in multiple areas.
Ability to make sound decisions and recommendations to drive business solutions.
Ability to communicate statistical and technical ideas and results to nontechnical clients.
Ability to work independently and complete projects within established timeframes.
Ability to manage competing priorities and take initiative.
General business and industry acumen, including turning data into information and delivering profit and performance.
Read and sign HOPCo’s Mission, Vision, and Values.

Nice To Haves

Bachelor’s degree preferred; an undergraduate degree in mathematics, actuarial science, business, finance, or a related field is preferred.
Experience with actuarial analysis and methodologies.

Responsibilities

Lead or participate in complex medical economics projects, including medical cost savings, trend, and risk assessment initiatives, and identify and complete key deliverables.
Apply statistical analysis methods to develop, validate, and execute algorithms, statistical models, and reporting tools for applied research and business questions.
Provide medical cost trend analytics, assess variance to expectations, and determine forecasted contract terms for health insurer and risk-bearing provider clients.
Recommend data collection methods, metric definitions, and evaluation methods.
Develop studies, analyses, and presentation materials to inform decision makers.
Present results and recommendations to management across value-based care teams.
Work cross-functionally throughout the organization toward operational targets.
Present complex information in a way that multiple organizational levels can understand and use to make decisions.
Meet project commitments for quality and timely delivery.
Understand and investigate technical details.
Determine assigned projects’ data needs and assure data integrity.
Independently plan and conduct sophisticated analyses.
Perform other duties as assigned.