Medical Economics Analyst III

Job Summary:The Medical Economics Analyst III is responsible for being proficient in identifying, quantifying and modeling opportunities to reduce medical costs within the market and presenting summarized analytical findings and recommendations to management.Essential Functions:Identify and quantify cost savings initiatives to reduce medical costs within the marketsBuild financial models to quantify impact of medical cost reduction initiativesAssess overall health plan performance by analyzing medical cost, utilization trends, risk adjustment dynamics, revenue impacts, and identifying key drivers, outliers, and opportunities for optimizationCombine strong technical skills in SQL and Excel/Power BI with critical thinking, business acumen, and the ability to refine and edit analyses for accuracy and clarityExtract, manipulate, and validate large healthcare claims datasets using SQL and Microsoft Excel/Power BIDevelop tools to efficiently identify new opportunities for cost savingsPartner with various departments within organization to discuss, develop and solution medical cost reduction initiativesEvaluate the effectiveness of medical cost reduction initiativesPresent analytical findings and recommendationsSupport the intake, prioritization and coordinated execution of ad-hoc analytics requests from departments across the organizationPerform any other job duties as requestedEducation and Experience:Bachelor’s Degree or equivalent years of relevant work experience is requiredAdvanced degree is preferredMinimum of five (5) years of experience in healthcare analytics is requiredManaged care experience is requiredCompetencies, Knowledge and Skills:Advanced knowledge of healthcare data, including medical and pharmacy claims, EMR data, HIE data, UM data and demographic dataKnowledge of Medicaid, Medicare and other government sponsored healthcare programs is requiredAdvanced Excel proficiency (pivot tables, lookups, financial modeling, data validation)Advanced SQL skills (data extraction, joins, aggregations, subqueries)Ability to organize data in a way which facilitates inferences, conclusions and decisionsStrong analytical, problem solving and critical thinking skillsAbility to balance competing prioritiesDemonstrated written and verbal communication skillsLicensure and Certification:NoneWorking Conditions:General office environment; may be required to sit or stand for extended periods of timeCompensation Range:$83,000.00 - $132,800.00CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.Compensation Type (hourly/salary):SalaryOrganization Level Competencies Fostering a Collaborative Workplace CultureCultivate PartnershipsDevelop Self and OthersDrive ExecutionInfluence OthersPursue Personal ExcellenceUnderstand the BusinessThis job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.Originally posted on Himalayas