Medical Economics Consultant - Medicaid Segment C2V

Highmark HealthPittsburgh, PA
Hybrid

About The Position

This job is responsible for using medical cost analytics to provide fact-based strategic insights into emerging medical cost trends. Using large sets of data, the ideal candidate will create the story of medical cost trends in a way that is clear, concise and easily understandable. The incumbent will have proven detailed technical and analytical experience with strong communication and influencing skills. More specifically, will engage with matrix partners to develop the medical cost analytics to determine the value of business solutions. Using data driven analytics, the ideal candidate will: 1) develop the value of the programs, 2) track the outcomes of the programs, and 3) provide strategic insight into areas of focus/opportunities.

Requirements

  • Bachelor's Degree in Business, Health, Economics, Mathematics/Actuarial Sciences or other related area
  • 5 years of Medical Economics, Healthcare Analytics, Informatics and/or Actuarial Services in the health care payer sector
  • Proven analytical ability to drive independent work and meet business timelines and outcomes.
  • Strong Technical Data Skills (SAS / SQL, R, Tableau, Excel, etc.)
  • Demonstrated ability to work with business partners in communicating outcomes, partnering on analytics, and developing new approaches to breaking down a strategic hypothesis.
  • Experience in the healthcare Industry, with solid knowledge of emerging trends and challenges
  • Medical and pharmacy claims data experience.

Nice To Haves

  • Master's Degree in Business, Health, Economics, Mathematics/Actuarial Sciences or other related area

Responsibilities

  • Provide strategic/tactical insights into emerging medical cost trends.
  • Develop executive ready presentations explaining analytical findings in a clear concise manner.
  • Provide business areas with opportunity assessments of their strategic medical cost programs.
  • Coordinate savings opportunity projections and post implementation savings measurements.
  • Develop improved business case and savings estimate capabilities to enable more accurate and deeper projections.
  • Leverage analytical experience and knowledge to drive independent medical cost analytics; develop areas of opportunity using a fact-based analysis, present medical cost analytics and insight into claim cost drivers to key business partners.
  • Strong communication skills (verbal and executive quality presentations) to present clear, concise presentations of the detailed analytics.
  • Work in a matrixed work environment.
  • Partner with other departments in developing the full analytical story.
  • Other duties as assigned or requested.
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