Sr Medical Economics Analyst

Better-Health-Group•Tampa, FL

13d

About The Position

Our mission is Better Health. Our passion is helping others. What’s Your Why? Are you looking for a career opportunity that will help you grow personally and professionally? Do you have a passion for helping others achieve Better Health? Are you ready to join a growing team that shares your mission? Why Join Our Team: At Better Health Group, it’s our commitment, our passion, and our culture that sets us apart. Our Team Members make a difference each and every day! They support our providers and payors, ensuring they have the necessary tools and resources to always deliver best-in-class healthcare experiences for our patients. We don’t just talk the talk - we believe in it and live by it. Be part of a team that shares your passion and drive, and start living your purpose at Better Health Group. Responsibilities Position Objective: The Senior Medical Economics Analyst plays a critical role in analyzing and optimizing medical cost trends, healthcare utilization, and financial performance within value-based care models. This position combines advanced data analytics, financial modeling, and strategic evaluation to provide actionable insights that support payors, providers, and executive leadership. Collaborating with Provider Operations and key stakeholders, the Senior Analyst develops reports, dashboards, and analytical frameworks to drive cost containment strategies, resource optimization, and operational efficiency. This high-impact role requires strong analytical skills, programming expertise, and a deep understanding of Medicare Advantage, healthcare economics, and regulatory compliance. Contributes to strategic decision-making by identifying opportunities for financial improvement while ensuring alignment with organizational and CMS guidelines.

Requirements

Bachelor’s Degree in Business, Finance, Computer Science, Engineering, Economics or related field preferred.
4+ years of professional experience in claims-based healthcare analytics with a payer, provider, clinical vendor, managed care, or related healthcare consulting entity.
2+ years of professional experience in Medicare / Medicare Advantage.
Experience working with a health plan or managed service organization.
Advanced or higher proficiency in Microsoft Excel.
Advanced or higher proficiency in PowerQuery, PowerPivot or PowerBi.
Advanced or higher proficiency in SQL or database/statistical programming languages.
Exceptionally strong analytical abilities, with a track record of identifying insights from quantitative and qualitative data.
Familiarity with healthcare reimbursement methodologies and calculations such as DRGs, Revenue Codes, CPT Codes, bundled payments, etc.
Working knowledge of healthcare claims; specifically, differences between institutional vs professional billing and various sites of care/service.
Ability to work independently with limited oversight.
Strong verbal and written communication skills across all levels of the organization.
Ability to juggle multiple priorities and make things happen in a fast-paced, dynamic environment; strong bias for action.
Self-starter who is able to drive complex analysis and who is able to manage quantitative planning/processes.
Ability to strategically develop, prioritize, and drive high-level initiatives while also being hands-on, detail-oriented, and willing to execute tasks as needed.
Physical ability to sit, stand and move freely about the office.
Must be able to remain in a stationary position up to or exceeding 50%.
Ability to stand, walk and sit for long periods.
Ability to bend, stoop, kneel, squat, twist, reach, and pull.
Constantly operates a computer and other office productivity machinery, such as copy machine, and computer printer.
Has a contagious and positive work ethic, inspires others, and models the behaviors of core values and guiding principles.
An effective team player who contributes valuable ideas and feedback and can be counted on to meet commitments.
Is able to work within the Better Health environment by facing tasks and challenges with energy and passion.
Pursues activities with focus and drive, defines work in terms of success, and can be counted on to complete goals.

Responsibilities

Extracts, manages, and analyzes healthcare claims, eligibility, and pharmacy data to identify trends, insights, and outliers using industry-standard metrics such as PMPM, Utilization per 1000, and Unit Cost.
Develops and implements financial models and analytical frameworks to evaluate medical cost trends, healthcare utilization patterns, and overall service fund performance.
Conducts in-depth research and analysis of complex healthcare data to support cost containment, efficiency improvements, and strategic decision-making.
Utilizes advanced programming and data analytics tools to explore, examine, and interpret large datasets for business intelligence and financial forecasting.
Identifies opportunities for cost savings and optimization within healthcare operations while ensuring the quality of care is maintained.
Analyzes provider contracts, payer agreements, and vendor partnerships to assess financial impact and alignment with organizational objectives.
Collaborates with medical management teams to analyze utilization patterns and recommend resource allocation improvements.
Engages with health plans, regulatory agencies, and internal stakeholders to align data reporting requirements and compliance with industry regulations.
Presents complex financial and operational analysis to executive leadership, offering actionable insights to drive strategic initiatives.
Reviews and maps health plan and regulatory data files for extraction, transformation, and integration into standardized data structures.