Medical Economics Consultant

Highmark Health•Carolina, PA

9d•Onsite

About The Position

This position uses medical cost analytics to provide fact-based strategic insights into emerging medical cost trends. The consultant works with large datasets to communicate findings clearly and concisely, and partners across a matrixed organization to develop analytics and determine the value of business solutions. The role evaluates program value, tracks program outcomes, and identifies strategic areas of focus and opportunity. The position requires detailed technical and analytical experience, strong communication and influencing skills, and the ability to work independently while partnering with business areas and other departments. It is office-based and includes occasional travel between work sites. The role is subject to company ethical, legal, privacy, and information-security requirements, including HIPAA and the company’s Code of Business Conduct. The pay range is $79,300 to $127,100. Base pay depends on factors including qualifications, experience, expected contributions, internal peer equity, market, and business considerations; geographic differentials may apply.

Requirements

Bachelor’s degree in Business, Health, Economics, Mathematics/Actuarial Sciences, or a related area.
Five years of experience in 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, including SAS, SQL, R, Tableau, or Excel.
Ability to communicate outcomes to business partners, partner on analytics, and develop new approaches to testing strategic hypotheses.
Healthcare industry experience with solid knowledge of emerging trends and challenges.

Nice To Haves

Master’s degree in Business, Health, Economics, Mathematics/Actuarial Sciences, or a related area.
Strong coding background in R, R Shiny, Python, SQL, or similar tools.
Experience building dashboards in Tableau, Power BI, or R Shiny.

Responsibilities

Provide strategic and tactical insights into emerging medical cost trends.
Develop executive-ready presentations that clearly and concisely explain analytical findings.
Extract, summarize, and analyze large datasets using SAS, SQL, or similar tools.
Assess strategic medical cost programs and identify opportunities for business areas.
Coordinate savings opportunity projections and post-implementation savings measurements.
Improve business case and savings estimate capabilities to support more accurate and deeper projections.
Independently conduct medical cost analytics and identify opportunities through fact-based analysis.
Present medical cost analytics and insights into claim cost drivers to key business partners.
Communicate detailed analytics through clear, concise presentations and verbal communication.
Work in a matrixed environment and partner with other departments to develop the full analytical story.
Perform other duties as assigned or requested.
Comply with applicable laws, company policies, HIPAA, privacy and information-security requirements, and the Code of Business Conduct.