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Medical Economist- Associate- Expert

3 months ago

Harrisburg, Pennsylvania, United States Health Advocates Network, Inc. Full time
Medical Economist- Associate- Expert

Pay Rate:
$39 / hour

Minimum Qualifications

Possess Bachelor's Degree, and

At least two (2) years of experience doing medical economic analyses

A working knowledge of inpatient and outpatient medical industry operations or claims analysis to identify aberrant billing patterns

High level proficiency in:
SAS, SQL, data mining software and Microsoft Office Suite, including Access Excel, Power Point and Word

Experience in accessing. using and analyzing complex medical information databases

(A good working knowledge of Medicaid/Medical Assistance a plus, but not required)

'

Role Description:
Assist in the design and conduct of:

Fiscal and program analyses to support Pennsylvania Medical Assistance Program decision-making processes.

Analyses to support medical assistance business operating decisions and for tracking, reporting and controlling of Medical Assistance costs.


Analyses to support the development of effective provider network management and reimbursement strategies or identification of abuse or waste in the Medical Assistance program.

Cost benefit analyses for new Medical Assistance initiatives


Medical Assistance cost trend analyses by geography, services provider type, place of service and other factors to Client trends and suggest action plans.

Fiscal and impact analysis of potential cost containment initiatives.

Large data set analyses to determine whether targeted cost savings were achieved or to identify future savings targets

Analyses of various data sets to recommend payment levels and provide fiscal impact estimates

Development and maintenance of healthcare payment reconciliation systems

Participate in meetings to advise Commonwealth staff on work results.

Prepare summary level papers and defend analyses completed.

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