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    Senior Medical Economics Analyst - New York, United States - HealthFirst

    HealthFirst
    HealthFirst New York, United States

    3 weeks ago

    Default job background
    Full time
    Description
    Job Description Summary
    The Senior Medical Economics Analyst (Sr. MEA) provides support and consultation to the Medical Economics team within Finance through analyzing key business issues related to cost, utilization and revenue for multiple Healthfirst products. As the Sr. MEA, you will design and develop reports to monitor health plan performance and identify the root causes of medical cost trends. With those root causes identified, you will drive innovation by creating tools to monitor trend drivers and provide recommendations to senior leaders for affordability opportunities.

    Duties & Responsibilities:

    • Analyze the financial performance of all Healthfirst products, identify favorable and unfavorable trends, develop recommendations to improve trends, communicate recommendations to management
    • Lead projects to completion by contributing to ad-hoc data analyses, development, and presentation of financial reports.
    • Serve as subject matter expert on developing financial models to evaluate the impact of provider reimbursement changes.
    • Provide data driven analytics to Finance, Claims, Medical Management, Network, and other departments to enable critical decision making.
    • Support Financial Analysis projects related to medical cost reduction initiatives.
    • Support Medical Management by assisting with Return on Investment (ROI) analyses for vendors to determine if their financial and clinical performance is achieving desired results.
    • Keep abreast of New York Medicaid and Medicare reforms and their impact on Healthfirst and their owner hospital performance.

    Minimum Qualifications:

    • Must have a Bachelor's degree from an accredited institution majoring in Math, Finance, Actuarial Science, Public Health or Economics
    • Analytical work experience within the healthcare industry (i.e. hospitals, network, ancillary, medical facilities, healthcare vendor, commercial health insurance company, large physician practices, managed care organization, etc.)
    • Work experience with SAS and/or SQL where you have created queries, pulled large data sets and performed data manipulations/analysis.
    • Work experience with MS Excel functions that include working with large data sets, creating standardized reports, utilizing vLookups and advanced functions/formulas; creating, using and interpreting pivot tables, filtering and formatting.
    • Knowledge of healthcare financial terms such as cost, utilization, Per Member Per Month (PMPM) and revenue.
    • Basic understanding of Medicaid and Medicare programs or other healthcare plans.
    • Self-motivated, creative problem solver who can work independently and collaborate through strong communication and interpersonal skills.

    Preferred Qualifications:

    • Strong project management experience and ability to handle multiple projects in a fast-paced environment.
    • Experience in modeling financial impact of provider reimbursement changes.
    • Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms.
    • Understanding of value-based risk arrangements.
    • Experience using Tableau.

    WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

    If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to or calling In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.

    EEO Law Poster and Supplement

    All hiring and recruitment at Healthfirst is transacted with a valid "" email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not , or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.

    Hiring Range*:

    • Greater New York City Area (NY, NJ, CT residents): $79,300 - $114,580
    • All Other Locations (within approved locations): $69,800 - $103,870

    As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

    In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

    *The hiring range is defined as the lowest and highest salaries that Healthfirst in "good faith" would pay to a new hire, or for a job promotion, or transfer into this role.

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