The Medical Economics Analyst performs detailed statistical analysis related to the organization’s service delivery. The Analyst will create and manage reports that monitor care utilization, premium, and MLR. The Analyst will support the Director of Medical Economics in identifying potential cost of care initiatives and will work closely with other areas of the business to monitor 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) for onsite team meetings as needed.
Responsibilities & Duties
Care Utilization Analysis
- Analyze and monitor care utilization through the lens of Medical Economics Metrics. Including but 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
- Develop and maintain ad hoc care utilization reporting tools for business stakeholders
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
Reporting and Data Visualization
- Utilize SQL, Excel and MicroStrategy to develop and maintain dashboards, reports, and other data visualizations for various business stakeholders
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 three (3) 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.
Employment for this position is contingent upon a satisfactory background and credit check, which will be performed after acceptance of an offer of employment and prior to the employee's start date.
Salary Range
$60,2341-$76,799/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
- Dress flexibility
