As a Medical Economics Analyst, you will provide consultative support and medical cost-based analysis of markets and network initiatives. You will be responsible for consulting with network and clinical management on opportunities to improve our company’s discount position and strategic cost and utilization initiatives and is essential to managing conflicting priorities and multiple projects. As part of the Medical Expense Review (MER) team, you will prepare analytic exhibits and manage both long and short-term projects, working collaboratively with local market leaders to accomplish tasks and goals that will improve the care we give our patients. You will also analyze and research utilization and unit cost medical costs drivers, turn data into usable information by telling the story through data visualization, support the development of scoreable action items by identifying outlier cost issues, perform drill-down analysis to identify medical cost trend drivers, advise network of contracting opportunities to mitigate future trends, own, track, and document all aspects of related work from beginning to end of a project, and work with Excel, Power Point, Power BI, and Web-based query tools (data warehouse). Required qualifications include 6+ months of experience in analytics or finance or equivalent experience. Preferred qualifications include experience within the healthcare industry, experience with key managed care functions including provider contracting, benefit design, medical management as well as knowledge of business functions and impact on financials (underwriting, sales, product development, network management), and experience working with medical and pharmacy claims. Bachelor's degree preferred.
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