Healthcare Medical Economics Senior Analyst - Boston, United States - Commonwealth Care Alliance

Description

Why This Role is Important to Us

The Sr. Associate will support Medical Economics data and analytics. He/She will work on trend analytics and reporting and support monthly production activities within the Actuarial Services department. The Actuarial Services Department makes extensive use of SAS and SQL programs to produce the data and analyses required to answer questions related to medical expenses, medical utilization, and premium revenue.

What You'll Be Doing

• Value and track new initiatives to reduce medical cost and right-size utilization.
• Develop and present timely, accurate, and actionable data analytics about medical expense and revenue trends.
• Translate complex or vague business problems into concrete analyses to answer key questions and drive business value.
• Develop presentation materials that articulate the problem statement, methodology, key takeaways, and recommendations for a diverse set of stakeholders ranging from senior leadership to line managers.
• Develop robust ROI processes to analyze internal initiatives and external arrangements.
• Be an analytic partner with stakeholders from clinical, network contracting, claims, and medical management and provide analytic support and thought leadership.
• Represent medical economics in senior leadership and utilization management meetings.
• Coordinate with cross functional teams, including Business Intelligence, IT, Operations, Clinical and Medical Management
• Document current processes and workflows.
• Mentor junior analysts and offshore staff.
• Other duties as assigned.

What We're Looking For

Education Required:

• BA/BS in Mathematics, Economics, Healthcare, or other quantitative discipline required

Experience Required:

• 5+ years Healthcare analytics experience. Knowledge of financial terminology like PMPM, utilization per k, unit cost
• Work experience with SAS, SQL, or Python in extracting ,manipulating, and analyzing large datasets
• Experience working with Excel with large datasets, VLOOKUP, pivot tables, and advanced functions/formulae
• Experience creating presentations and presenting to stakeholders

Knowledge, Skills Abilities Required:

• Strong organizational, analytic, and problem-solving skills
• Work independently with support from Med Econ director and colleagues
• Independent and self-motivated candidate who can drive a project from beginning to end
• Basic understanding of Medicare and Medicaid programs
• Interpersonal communication skills enabling the incumbent to collaborate effectively within department and across functions.

Language(s) Required:

• English

Other Required:

• Standard office equipment