Remote Medical Economics Analyst

Healthcare Outcomes Performance Company•Phoenix, AZ

19h•Remote

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 methods 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, metric definition, and evaluation methods; develops studies, analyses, and presentations for decision makers; and presents results and recommendations to management across value-based care teams. The role works cross-functionally toward operational targets, communicates complex information to varied audiences, and ensures project quality and timely delivery. It also evaluates project data needs and data integrity and independently plans and conducts sophisticated analyses. Other duties may be assigned.

Requirements

Three or more years of healthcare industry experience in health insurance, value-based care, or healthcare administration.
Two or more years 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.
Two or more years analyzing capitated and fee-for-service provider contracts across Medicare, Medicare Advantage, Commercial, and Medicaid plans.
Two or more years working with database management systems such as SQL Server, DB2, or SAS.
Proficiency in SQL and healthcare data analytics.
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 non-technical clients.
Ability to work independently and complete projects within established timeframes.
Self-starter with ability to juggle competing priorities.
General business and industry acumen, ability to turn data into information, and finance skills related to delivering profit and performance.
Willingness to read and sign HOPCo's Mission, Vision, and Values.

Nice To Haves

Bachelor’s degree preferred, particularly in mathematics/actuarial studies, business, finance, or a related field.
Experience with reporting tools such as Power BI or similar.
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 complete key deliverables.
Apply statistical analysis methods to develop, validate, and execute algorithms, statistical models, and reporting tools.
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 to achieve operational targets.
Communicate complex information so that multiple organizational levels can use it to make decisions and meet business objectives.
Meet project commitments for quality and on-time deliverables.
Understand and probe into technical details.
Evaluate project data needs and assure data integrity.
Independently plan and conduct sophisticated analyses.
Perform other duties as assigned.