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    Healthcare Analyst - New York, United States - Healthfirst

    Healthfirst
    Healthfirst New York, United States

    3 weeks ago

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    Description


    The Healthcare Analyst (HCA) provides support through the research and investigation of business issues related to cost, utilization, and revenue data for multiple Healthfirst products.

    The HCA will identify/monitor cost and utilization trends and the root causes in health plan trend performance and provide recommendations for solutions.


    The HCA will interact with divisional subject matter experts, Network, and IT and other areas of the organization to provide support in various tasks related to achieving business objectives.

    The HCA will contribute to a broad set of projects across the department. This position requires an individual with emerging skills who enjoys working in a fast paced and challenging environment.

    The HCA works in partnership with other areas of Finance to provide key insights and analysis to our internal stakeholders across departments like operations and medical management as well as our external hospital and provider networks.


    Analyze the financial performance of all Healthfirst products, identify favorable and unfavorable trends, develop recommendations to improve trends, communicate recommendations to management.

    Create financial models to evaluate the impact of provider reimbursement changes.


    Gather data and conduct ad hoc analyses as directed by other department team members and assist with the development and presentation of analytical data reports.

    Support department projects related to medical cost reduction initiatives.


    Assist 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.

    Provide support to the department's performance improvement work groups.

    Monitor costs and revenue trends and assist in understanding trends.

    Understand and analyze impacts of new program changes.

    Responsible for creating, modifying, and updating analysis for Provider Organizations.

    Responsible for contract analysis and fee schedule modeling.

    Maintain current project logs and work plans on assignments.

    Additional duties as assigned


    Minimum Requirements:
    Bachelor's degree or higher from an accredited institution with a concentration in Finance, Accounting, Business, or Healthcare Administration

    Experience in modeling financial impact of provider reimbursement changes.

    Self-motivated, creative problem solver who can work independently and collaborate through strong communication and interpersonal skills.

    Strong project management experience and ability to handle multiple projects in a fast-paced environment.


    Preferred Qualifications:


    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.

    Experience with SAS, SQL and Tableau.

    Current or previous work experience with a Health insurance company.

    Experience with analyzing medical cost and utilization trends.

    Knowledge of Medicaid and Medicare programs/

    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): $67,200 - $97,155

    All Other Locations (within approved locations): $59,800 - $88,910


    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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