Job Description - Medical Economics Sr Analyst (Full-time Remote, North Carolina Based)
The Medical Economics Sr. Analyst performs detailed statistical analysis related to the organization’s service delivery. The Sr. Analyst will create and manage reports that monitor care utilization, premium, and MLR. They will support the Director of Medical Economics in identifying potential cost of care initiatives. The Sr. Analyst will also act as the lead on liaising with business stakeholders to execute these initiatives and evaluate their efficacy.
This position is full-time remote. Selected candidate must reside in North Carolina and be willing to travel to the home office (Morrisville, NC) foronsite team meetings as needed.
Responsibilities & Duties
Care Utilization Analysis
Act as team lead for analysis and monitoring of care utilization through the lens of Medical Economics Metrics. These include, but are not limited to: PMPM, Utilization per thousand, prevalence and intensity
Develop and maintain reports related to Care Utilization, Premium and Pay for Performance plans
Monitor monthly utilization patterns and create utilization forecasts
Identify cost drivers and work with the Director of Medical Economics to develop action plans
Work with the business to identify opportunities for ad hoc reporting related to Care Utilization. Identify and liaise with key stakeholders to define reporting requirements
Financial Forecasting
Create and maintain financial models to assess the impact of Medical Cost Action Plans
Assess the financial impact of rate and policy changes made by the State of North Carolina to the Medicaid Tailored Plans
Collaborate with Utilization Management to perform cost impact analyses when new services are introduced, and when service definitions for existing services are modified or changed
Reporting and Data Visualization
Utilize SQL, Excel and MicroStrategy to develop and maintain dashboards, reports, and other data visualizations for various business stakeholders
Prepare reports for business stakeholders using data visualization best practices. Present analytical insights to the business in a succinct, easily-understood format that facilitates operational decision-making
Research and Collaboration
Stay up to date on industry trends, regulations and healthcare policies that may impact Alliance’s financial performance
Collaborate with cross-functional teams, including Utilization Management and Provider Network, to develop data-driven recommendations and actionable strategies
Minimum Requirements
Education & Experience
Bachelor’s Degree in Healthcare Management, Health Informatics, Economics, Statistics, Finance, or a related field and at least five (5) years of experience in finance or analytics.
Knowledge, Skills, & Abilities
Thorough knowledge of financial data analysis and methodology, preferably with experience in a healthcare field
Strong Microsoft Office skills
Expert proficiency in Excel and SQL
Strong Business Acumen
Strong analytical and quantitative skills
Problem solving skills
Strong written and verbal communication skills for a diverse work group, and an ability to present complex data to non-technical stakeholders
Ability to work independently
Ability to develop strong working relationships with divergent groups and communicate technical concepts to lay persons
Ability to solicit cooperation from persons and departments throughout the organization
Ability to resolve complex problems that require the evaluation of alternative methods and solutions;
Ability to set objectives and prioritize workflow
Ability to make prompt decisions on complex matters and make evaluations concerning day to day operations
Ability to prepared concise and accurate reports and plans.
Salary Range
$69,592-$88,729/Annually
Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity.
An excellent fringe benefit package accompanies the salary, which includes:
Medical, Dental, Vision, Life, Long Term Disability
Generous retirement savings plan
Flexible work schedules including hybrid/remote options
Paid time off including vacation, sick leave, holiday, management leave
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