Senior Healthcare Economics Analyst

Summary:

• Work with other team leaders to improve operational efficiencies and resource allocations for improved performance of the EmblemHealth plans.
• Responsible for running queries and providing required analysis to understand related drivers (such as medical cost and utilization), and to provide insightful commentary and sensitivity modeling analysis.
• Develop data-driven analysis for decision making on how EmblemHealth purchases, manages, and influences the cost of care for current and prospective members.
• Extract, analyze, and interpret data for more complex insights related to cost drivers and to manage the escalation of issues that impact costs, and impact of health cost containment initiatives.
• Provide consultative subject matter expertise to aligned business areas to demonstrate analytics rooted in data.

Responsibilities:

• Ensure data integrity is maintained throughout the reporting lifecycle.
• Implement reporting and reconciliation workflows and document processes.
• Responsible for experience studies and medical trend studies.
• Perform research and collection of data, including data mining and reporting, which is provided to various customers inside and outside the department.
• Implement automation of manual reporting and analysis of business implications and trends.
• Lead efforts to continually improve data capabilities and quality of department analysis and reporting.
• Create, develop, and design analytics and reporting to measure or estimate financial impact of health plan business problems and potential or actual solutions, addressing escalated issues with subject matter expertise.
• Lead and manage several corporate and health cost containment initiatives, supporting staffing to deliver results across all functions within Medical Economics.
• Develop research and analytic processes to review financial data to draw conclusions for senior leadership.
• Represent the department to internal and external partners with presentation of data and results for use in administering specific programs and processes related to medical expense and utilization.
• Present analytical findings to internal business partners, leading discussions and providing delivery of further analysis.
• Analyze business problems related to financial experience of the health plan, particularly related to how care is purchased, managed, or other factors influencing cost of care.
• Perform additional duties as assigned.

Requirements:

• BA/BS in Mathematics, Statistics, Economics, Healthcare or related discipline required; Master's preferred.

• 4 - 6+ years' experience working in a healthcare setting (within a provider health system or health insurance company) required

• Ability to query, summarize, and manipulate data using SQL or SAS required

• High level of proficiency with MS Office (Word, Excel, PowerPoint, Outlook, etc.), with an emphasis on Excel required

• Experience working in a healthcare setting (within a provider health system or health insurance company) preferred

• Experience working with healthcare data including but not limited to claims, testing results and pharmacy data required

• Strong communication skills (verbal, written, presentation, interpersonal) required

• Experience preparing/presenting dashboards and data using a data visualization tool such as Tableau preferred

Additional Information

• Requisition ID: 2603O
• Hiring Range: $68,040-$118,800