Salary: 90K - 100K + bonus
Schedule: Hybrid (three days in office)
SUMMARY OF JOB DUTIES:
Medical Economics Analyst / Senior Analyst will be responsible for working with Medicare Advantage and DCE membership files to produce panel reports, identify new and termed members, and other Medicare Advantage/DCE membership reporting.
ESSENTIAL JOB FUNCTIONS:
- Must be proficient in using SQL Server
- Consolidates monthly patient rosters from payers and disseminates standardized list to various departments (Value Based, Finance, Market Clinical Operations, etc.).
- Develops monthly process to identify new and termed members and work across multiple data systems to consolidate demographic details.
- Communicates with operational teams to meet their data and reporting needs.
- Tracks business requirements from payers regarding cost reallocations and monitors case outcomes.
- Develops monthly processes and procedures for identifying candidates for potential cost reallocations and completes accompanying forms, if applicable, for payer submission.
- Obtain and analyze data to understand how to continually improve processes, procedures and execution.
- Maintain knowledge of current healthcare trends by reading appropriate literature and attending related conferences and/or seminars.
- Relied upon to apply business knowledge to analytics projects and provide value-added insights to directly impact business outcomes.
Qualifications
KNOWEDGE/SKILLS/ABILTIES:
- Proficient in using SQL Server is a must
- Excellent written and verbal communication skills and ability.
- Proficient in Microsoft Office such as Excel, Word, Access, etc.
- Experience with using Power BI strongly preferred.
- Strong analytical, organizational, and problem-solving skills.
- Experience working with complex data sets across claims, lab, financial, clinical outcomes, and external sources.
- Knowledge of medical data structures including, but not limited to (ICD10, CPT, HCPCS, NDC)
- Knowledge of different reimbursement models (DRG, APC, AWP+, Cost plus, PDGM)
- Position is based in Jacksonville, FL
- A relocation package may be available for the right candidate
MINIMUM REQUIREMENTS
- Bachelor's degree in Business, Health Care Administration, Mathematics, Finance, Health Informatics, or related field.
- Proficient in SQL Server and Microsoft Suite
- Requires 1- 2+ years of experience in healthcare-related data analysis is strongly preferred.
- Masters in relevant field preferred and can be substituted for 2 years' experience.
