Extract, analyze and interpret data to produce both standard claims and utilization trend reporting and ad hoc analysis requests.
Support all functions within Medical Economics including monitoring of specific corporate and health cost containment initiatives.
Principal Accountabilities
Support research and analysis of financial data; draw conclusions and provide consultation to internal and external partners for use in administering specific programs and processes related to medical expense and utilization.
Perform detailed analyses, including accumulation of data, financial modeling, and reporting of outcomes.
Assist the business units to identify trend outliers, analyze the trend drivers and perform the work necessary to facilitate the discussion on possible solutions.
May create comparative views of unit cost information that contracting teams can utilize to identify outlier contracts.
Conduct ongoing monitoring of medical cost savings initiatives.
May provide detailed analytics to provider network contracting teams in support of the negotiation process.
Develop ad hoc views of data that illustrates underlying trend issues for both cost and utilization.
Perform additional duties as assigned.
Education, Training, Licenses, Certifications
BA/BS Required in Mathematics, Economics, Healthcare or other quantitative discipline required
Relevant Work Experience, Knowledge, Skills, and Abilities
3 - 5 years' experience working in a healthcare setting (within a provider health system or health insurance company) required
Experience working with healthcare data including but not limited to claims, testing results and pharmacy data required
High level of proficiency with MS Office (Word, Excel, Powerpoint, Outlook, etc.), with an emphasis on Excel required
Strong communication skills (verbal, written, presentation, interpersonal) required
Experience preparing/presenting dashboards and data using a data visualization tool such as Tableau preferred
Strong data querying skills using tools such as SQL or SAS Enterprise Guide required