Senior Medical Economics Analyst

Martin's Point Health Care•Portland, ME

31d

About The Position

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015. Position Summary The Senior Medical Economics Analyst – Pharmacy is responsible for performing advanced analytical work to evaluate pharmacy utilization, drug cost trends, and program performance. This role provides strategic insights to support pharmacy benefit design, formulary management, and value-based initiatives. The analyst partners closely with pharmacy, actuarial, clinical, and finance teams to identify cost-saving opportunities and improve overall healthcare value. Job Description Employees are expected to work consistently to demonstrate the mission, vision, and core values of the organization.

Requirements

Bachelor’s degree in business, health administration, health policy, finance or a related field required.
5+ years of managed care or similar experience including managed care finance, medical economics, pharmacy management, and clinical program cost-effectiveness analytics.
Experience working with actuarial/pricing and other key financial departments.
Knowledge of or experience with Medicare Advantage programs.
Knowledge of or experience with medical cost, clinical or provider contracting analysis.
Excellent oral, written and presentation skills to support management briefings and presentations both internal and external.
Demonstrated understanding of and alignment with Martin’s Point Values.
Demonstrated proficiency retrieving and manipulating large data sets (SQL, Cognos).
Ability to create insightful dashboards and visual analytics using data visualization tools (Power BI, Tableau).
Ability to develop tools designed to monitor and analyze cost and utilization trends.
Ability creating, reconciling, summarizing, and analyzing data.
Proven ability to organize work, simultaneously work on many activities and projects and meet deadlines directly or through matrix management.
Demonstrated ability to work cross-functionally to develop and implement new programs or services.
Strong track record of building internal and external collaborative relationships.
Broad understanding of managed care business – medical expense trends, financial risk arrangements, medical care management programs, managed care products, risk management.
This position is not eligible for immigration sponsorship.

Responsibilities

Analyzes pharmacy claims and utilization data to identify cost and utilization drivers, drug mix shifts, and emerging trend patterns.
Evaluates the financial impact of formulary changes, rebate programs, and utilization management strategies (e.g., prior authorization, step therapy).
Conducts ROI analyses for pharmacy interventions, clinical programs, and vendor initiatives.
Supports annual pharmacy budget and forecast processes, including trend projections and variance explanations.
Develops and maintain regular pharmacy trend and performance reports for internal stakeholders and executive leadership.
Provides actionable insights to inform drug formulary decisions, rebate negotiations, and medical-pharmacy integration strategies.
Creates dashboards and visualizations to communicate pharmacy spend trends, key performance indicators (KPIs), and cost savings opportunities.
Partners with the pharmacy operations, clinical pharmacy, and contracting teams to assess the financial impact of drug pricing and utilization policies.
Works with clinical teams to evaluate the total cost of care and identify opportunities for better integration between medical and pharmacy benefits.
Collaborates with data analytics and IT teams to enhance pharmacy data integrity, automation, and analytics capabilities.