Medical Economics Analyst, Health Plan

Sanford Health

1d • $29 - $47

About The Position

The Medical Health Economics Analyst uses data analysis to identify medical cost trends, evaluate financial performance, and provide actionable insights to support strategic business decisions. This role is vital for cost containment and improving plan performance.

Requirements

• Bachelor’s degree in Economics, Statistics, Finance, Public Health, Mathematics, Actuarial Science, Data Analytics or related quantitative discipline required.
• 1-3 years of progressive analytical experience in a healthcare setting (health insurance, managed care, or health system) is required.
• Strong analytical, problem-solving, critical thinking, and communication skills are vital for success in this role.
• Proficiency in SQL for data extraction and manipulation is a must.
• Advanced Microsoft Excel skills, including pivot tables and complex formulas, are essential.

Nice To Haves

• Knowledge of STARs and Risk Adjustment preferred.
• Experience with data visualization tools like Tableau or Power BI is highly valued.
• Familiarity with statistical tools such as SAS, R, or Python is often a plus.

Responsibilities

• Analyze complex medical claims, pharmacy data, and other healthcare data sets to identify emerging cost and utilization trends, patterns, and outliers.
• Develop financial models to evaluate the financial impact of new clinical programs, new initiatives, and value-based agreements.
• Identify opportunities for medical cost reduction, quantify potential savings, and measure the return on investment (ROI) of implemented initiatives.
• Create clear, concise reports, dashboards, and presentations using data visualization tools to communicate complex findings and actionable insights to a variety of stakeholders, including senior management and clinical departments.
• Work closely with accounting, actuarial, underwriting, clinical, health services delivery and network management teams to provide analytical support for decision-making and strategic planning, such as informing payer negotiations and risk adjustment strategies.
• Ensure the accuracy and integrity of data used in analyses, and prepare well-organized project documentation including methodologies and key decision points.
• Respond to ad-hoc data analysis requests from various departments, providing timely intelligence related to specific business problems.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level