Medical Economics Advisor
We are looking for a highly skilled and independent Senior Medical Economics Analyst to lead advanced analytics initiatives that support our clients value-based care strategies. This role is ideal for a seasoned healthcare data expert who thrives in a hands-on, individual contributor capacity and is passionate about transforming care delivery through data.
The ideal candidate will bring deep expertise in Medicare Advantage, SQL-based data analysis, and a strong understanding of value-based payment models, including risk adjustment, provider performance, and population health metrics.
Key Responsibilities:
- Serve as a lead analyst on initiatives that evaluate the financial and clinical performance of value-based care programs, including ACOs, shared savings, and Medicare Advantage contracts.
- Design and execute complex SQL queries to extract and analyze large-scale healthcare data, including claims, eligibility, and provider performance metrics.
- Develop actionable insights that inform strategic decisions around provider incentives, care management, and cost containment.
- Conduct impact analyses of clinical interventions, risk adjustment strategies, and quality improvement programs.
- Collaborate with cross-functional teams including clinical operations, finance, and provider relations to align analytics with organizational goals.
- Build and maintain dashboards and reports that track key performance indicators related to value-based care.
- Ensure compliance with CMS guidelines and internal data governance standards.
Qualifications:
Required:
- Bachelor's degree in Health Economics, Public Health, Statistics, or a related field (Master's preferred).
- 5+ years of experience in healthcare analytics, with a strong focus on Medicare Advantage and value-based care.
- Advanced SQL skills with the ability to write, optimize, and troubleshoot complex queries.
- Deep understanding of healthcare claims data, risk adjustment methodologies, and provider performance metrics.
- Experience working with CMS data and regulatory reporting requirements.
FAQs
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