Medical Economics Analyst

Accountabilities:

Lead or contribute to complex medical economics projects, including medical cost savings initiatives, trend analysis, risk assessments, and the identification of key deliverables.
Develop, validate, and implement statistical models, algorithms, and reporting tools to address business and research questions for internal and external stakeholders.
Conduct medical cost trend analyses, investigate variances against expectations, and support the forecasting of contractual terms for health insurers and risk-bearing healthcare providers.
Identify opportunities for cost management and recommend appropriate data collection methods, performance metrics, and evaluation approaches.
Design and conduct sophisticated analyses, ensuring data accuracy, integrity, and relevance to project objectives.
Prepare analytical reports, studies, and presentations that translate complex findings into clear, actionable recommendations for management and value-based care teams.
Collaborate with cross-functional stakeholders to support operational performance, achieve business targets, and drive effective decision-making.
Manage project commitments, ensuring the quality, accuracy, and timely delivery of analytical outputs.
Investigate technical details, independently manage analytical assignments, and perform additional responsibilities as required.
Requirements:
Bachelor's degree preferred, ideally in Mathematics, Actuarial Science, Business, Finance, or a related discipline.
At least 3 years of experience in the healthcare industry, particularly in health insurance, value-based care, or healthcare administration.
At least 2 years of experience analyzing healthcare claims and eligibility data, including medical cost and trend analysis, variance analysis, cost management opportunities, medical economics reporting, statistical analysis, and data modeling.
At least 2 years of experience analyzing capitated and fee-for-service provider contracts across Medicare, Medicare Advantage, Commercial, and Medicaid plans.
At least 2 years of experience working with database management systems such as SQL Server, DB2, or SAS.
Strong proficiency in SQL and healthcare data analytics, along with experience using reporting and visualization tools such as Power BI or equivalent platforms.
Advanced Microsoft Excel skills and working knowledge of Word, PowerPoint, and Access.
Knowledge of statistical analysis methods, healthcare cost drivers, and provider reimbursement methodologies. Experience with actuarial analysis and methodologies is an advantage.
Strong analytical thinking, problem-solving, project management, and business acumen, with the ability to translate complex data into meaningful business insights.
Excellent communication and presentation skills, including the ability to explain statistical concepts and technical findings to non-technical audiences.
Ability to work independently, manage competing priorities, meet deadlines, and make sound recommendations that support business performance.
A proactive, detail-oriented, and adaptable approach, with the willingness to investigate technical challenges and collaborate across teams.
Benefits:
Remote work opportunity within the United States.
Full-time employment.
Flexible work environment, with the option to work remotely or in a standard office setting.
Opportunities to contribute to meaningful healthcare analytics and value-based care initiatives.
Exposure to complex medical economics projects, healthcare financial analysis, and cross-functional collaboration.
Some travel may be required.
Salary, healthcare coverage, paid time off, and additional benefits have not been specified in the available job description.