Senior Medical Economics Analyst
eeking a highly skilled and data-driven Senior Medical Economics Analyst. This role is responsible for conducting complex financial and utilization analyses to support strategic decision-making across clinical, operational, and value-based care initiatives. The ideal candidate will have a strong background in healthcare data analytics, cost modeling, and managed care economics.
Key Responsibilities:
- Analyze healthcare cost, utilization, and quality data to identify trends, cost drivers, and opportunities for improvement.
- Develop and maintain financial models to evaluate the impact of clinical programs, benefit design changes, and provider performance.
- Support actuarial and underwriting teams with data-driven insights for pricing and forecasting.
- Collaborate with clinical, finance, and network teams to support value-based care initiatives and managed care strategies.
- Prepare and present reports, dashboards, and executive summaries to communicate findings and recommendations.
- Evaluate the financial performance of provider contracts, including shared savings and risk-based arrangements.
- Ensure data integrity and accuracy in all analyses and reporting.
Qualifications:
- Bachelor's degree in Health Economics, Statistics, Public Health, Actuarial Science, Finance, or a related field (Master's preferred).
- 4-6 years of experience in healthcare analytics, medical economics, or a related field.
- Strong understanding of healthcare reimbursement models, managed care, and value-based care.
- Proficiency in SQL and advanced Excel; experience with SAS, R, Python, or other statistical tools is a plus.
- Experience working with large healthcare datasets (claims, eligibility, EMR, etc.).
- Excellent analytical, problem-solving, and communication skills.
Preferred Skills:
- Familiarity with HEDIS, risk adjustment, and CMS/Medicaid programs.
- Experience with data visualization tools (e.g., Tableau, Power BI).
- Ability to work independently and manage multiple priorities in a fast-paced environment
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