Join one of our leading clients in Healthcare as a Medical Economics Advisor, supporting analytical needs across our Operations, Clinical, and Finance teams. You'll tackle complex medical economics questions using diverse data sources in this fast-paced role.
Responsibilities:
- Identify, monitor, and analyze healthcare cost drivers, utilization patterns, and reimbursement rates
- Research healthcare delivery topics, analyze data, and recommend solutions
- Analyze claims, membership, and prior authorization data for trends
- Provide actuarial support for Medicare Advantage plans
- Forecast revenue projections using experience with HCCs and RAFs
- Structure analytical results visually and meaningfully
- Collaborate with the Engineering team on data sourcing and analysis
- Perform ad-hoc requests and interpret contractual language
- Execute other duties and projects as needed
Requirements:
- Bachelor's degree in Math, Statistics, Actuarial Science, Economics, or a related field
- 4+ years of experience at a health plan, ACO, RBE, or consulting firm
- 4+ years in Value-Based Care
- Experience with HEDIS, STARS, and RAF Scores
- Proficiency in MS Excel, including formulas, PivotTables, PowerBI
- Experience with data mining, relational databases, and SQL preferred
- Experience creating product trend analyses
How to Apply: Send your resume with the subject line "Medical Economics Advisor Application". We look forward to hearing from you!
