Medical Economics Analyst---(Grade 18)
Under the supervision of the manager, the Medical Economics Analyst will provide accurate and timely analytical support to executives and senior management related to corporate-wide strategic decision making and medical expense savings by performing analytical projects. The candidate must have the analytical and technical skills necessary to execute each phase of an analysis, including information gathering through oral and written communication, methodological design, the ability to learn quickly and translate data into clear and actionable results, strong organizational skills and the ability to work independently. Technical tasks require an understanding of relational databases and large data structures as well as knowledge of SQL or SAS.
Requirements
· Responsible for performing analyses for all lines of business to support medical expense initiatives, provider network contracting strategies, and revenue maximization.
· Assist in the development of global budget, risk reward, and capitation payment models for use in new provider network contracting strategies in conjunction with all relevant stakeholders.
· Evaluate payment models in order to reconcile payment based on performance measures and determine impact on medical expense.
· Provide actionable analyses related to membership growth, network development strategy, and premium allocation based on an understanding of member demographics and profit and loss analysis.
· Apply knowledge of grouping or stratification tools (e.g.: DxCGs, CDPS, DRGs), for health risk-based identification, stratification, or adjustment.
· Apply concepts and tools of health care economics, such as cost- effectiveness and forecasting/trend studies, to enhance understanding of expense patterns across the products and geography.
· Develop methods for consistency and validity checking to assure accurate and meaningful results.
· Through clear written and oral communication, explain key analytical findings and work with subject matter experts to identify appropriate actions and monitor outcomes.
· Working on ad hoc requests, as assigned.
Additional duties
· Maintains professional growth and development through self-directed learning activities and involvement in professional, civic, and community organizations.
· Maintain professional growth through courses, cross-training, goal- setting, and other approaches.
· Constantly seeks to improve the analytic and business intelligence function by applying CQI principles.
Qualifications
· Bachelors degree in business, mathematics, economics, statistics, or finance or equivalent work experience of 7 to 10 years in an analytical role. Masters degree preferred.
· Minimum of 3 years experience working in a health care analytics role preferably in a managed care insurance environment. Requires an abstract thinker.
How to apply
Send your resume with a cover letter to careers@network-health.org. Please include the above Job Code in the subject line of your email. Or, mail them to:
Network Health
Attn: Human Resources
101 Station Landing
Fourth Floor
Medford, MA 02155
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If you have additional comments, please email Bob Reidy at rreidy@detma.org
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