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    Senior Healthcare Economics Analyst - New York, United States - Emblem Health

    Emblem Health
    Emblem Health New York, United States

    2 weeks ago

    Default job background
    Description

    Summary:

    • Work with other team leaders to improve operational efficiencies and resource allocations for improved performance of the EmblemHealth plans.
    • Responsible for running queries and providing required analysis to understand related drivers (such as medical cost and utilization), and to provide insightful commentary and sensitivity modeling analysis.
    • Develop data-driven analysis for decision making on how EmblemHealth purchases, manages, and influences the cost of care for current and prospective members.
    • Extract, analyze, and interpret data for more complex insights related to cost drivers and to manage the escalation of issues that impact costs, and impact of health cost containment initiatives.
    • Provide consultative subject matter expertise to aligned business areas to demonstrate analytics rooted in data.

    Responsibilities:

    • Ensure data integrity is maintained throughout the reporting lifecycle.
    • Implement reporting and reconciliation workflows and document processes.
    • Responsible for experience studies and medical trend studies.
    • Perform research and collection of data, including data mining and reporting, which is provided to various customers inside and outside the department.
    • Implement automation of manual reporting and analysis of business implications and trends.
    • Lead efforts to continually improve data capabilities and quality of department analysis and reporting.
    • Create, develop, and design analytics and reporting to measure or estimate financial impact of health plan business problems and potential or actual solutions, addressing escalated issues with subject matter expertise.
    • Lead and manage several corporate and health cost containment initiatives, supporting staffing to deliver results across all functions within Medical Economics including.
    • Develop research and analytic processes to review financial data to draw conclusions for senior leadership.
    • Represent the department to internal and external partners with presentation of data and results for use in administering specific programs and processes related to medical expense and utilization.
    • Present analytical findings to internal business partners, leading discussions and providing delivery of further analysis.
    • Analyze business problems related to financial experience of the health plan, particularly related to how care is purchased, managed, or other factors influencing cost of care.
    • Perform additional duties as assigned.

    Requirements:

    • BA/BS in Mathematics, Statistics, Economics, Healthcare or related discipline required; Master's preferred.
    * years of relevant, professional work experience required

    • Experience querying, summarizing, and manipulating data using SQL or SAS required
    • High level of proficiency with MS Office (Word, Excel, PowerPoint, Outlook, etc.), with an emphasis on Excel required
    • Experience working in a healthcare setting (within a provider health system or health insurance company) preferred
    • Experience working with healthcare data including but not limited to claims, testing results and pharmacy data required
    • Strong communication skills (verbal, written, presentation, interpersonal) required
    • Experience preparing/presenting dashboards and data using a data visualization tool such as Tableau preferred
    Additional Information


    • Requisition ID:
    • Hiring Range: $63,000-$110,000
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