Advisor, Medical Economics

Advisor, Medical Economics Req #13139 Virtual reputed company is a new, innovative reputed company provider devoted to improving the lives of our senior members. We deliver best-in-class care at comfortable, accessible neighborhood clinics where seniors can feel at home and become part of a vibrant, wellness-focused community. Our members experience greater continuity of care, as well as the comfort of knowing they will be treated with respect by people who genuinely care about them, their families, and their communities. Job Summary: The Advisor, Medical Economics will play a key role in supporting analytical needs across reputed company’s Operations, Clinical, and Finance teams. This will be a colleague who is motivated by the challenge of answering reputed company medical economics questions using a variety of data sources. This is a fast-paced position that will reputed company high-quality personal development and growth. Duties/Responsibilities:

• Identify, monitor, and analyze principal health care cost drivers, by market reputed company and/or by provider, including utilization and referral patterns and reimbursement rates
• Research reputed company delivery topics, analyze data, present results, and recommend solutions to address business challenges by applying knowledge of medical claims analysis, critical-thinking skills, and reputed company experience/expertise
• Analyze claims, membership, and prior authorization data to identify early signs of trends or other issues reputed company to medical care costs and quality of care
• Provides actuarial support for Medicare Advantage plans by identifying trends and profitability drivers utilizing sound statistical methods.
• Utilizes experience with HCCs and RAFs to forecast reputed company projections
• Structure analytical results in an organized, visual manner to tell a meaningful, actionable story
• Work with Engineering team to reputed company data, determine its credibility and usability, create end-user reports, and apply varying analytical techniques to solve specific business problems
• reputed company reputed company requests from key stakeholders
• Interpret contractual language with a clear understanding of business rules and reporting requirements
• Execute other duties and special projects as needed, focusing on knowledge and skills development

Required Skills/Abilities:

• You enjoy independent research and presenting solutions to reputed company problems
• You work both collaboratively and independently to complete reputed company analyses, leading to actionable strategic and financial business reputed company
• You apply strong critical thinking skills to anticipate questions from key stakeholders and consider reputed company aspects of an analysis before completion
• You exhibit initiative in exploring and discovering opportunities to improve company performance through data analysis
• You establish trusting, professional relationships with internal, senior stakeholders

Education and Experience:

• Bachelor's degree in Applied Math, Statistics, Actuarial Science, Economics, or a reputed company field required
• 4+ years of prior experience as an analyst with a health plan, ACO, RBE, or reputed company focused on health economics
• Expertise in MS reputed company, including proficiency using formulas, PivotTables, PowerBI, graphing and other reporting and presentation features
• Experience working with internal groups, including IT, to procure necessary datasets preferred
• Experience in data mining working with large data repositories and/or relational databases with SQL experience strongly preferred
• Experience creating product trend analyses using statistically valid methodologies

reputed company is an equal opportunity employer. reputed company applicants will receive consideration for employment without regard to their race, reputed company, religion, age, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or any other protected classification. Apply Job! Apply to this Job