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Sr. Healthcare Economics Analyst
Sr. Healthcare Economics AnalystEmblemHealth • New York, NY, United States
Sr. Healthcare Economics Analyst

Sr. Healthcare Economics Analyst

EmblemHealth • New York, NY, United States
30+ days ago
Job type
  • Full-time
Job description

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 : 1000002509

    Hiring Range : $68,040-$118,800

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    Economic Analyst • New York, NY, United States

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