Analyst, Medical Economics

2 months ago

Miami, Florida, United States Independent Living Systems Full time
About Us

Join us in making a career in Independent Living Systems, an industry leader in managing home and community-based programs for over 20 years. Independent Living Systems, LLC and its subsidiaries offer a comprehensive range of clinical and third-party administrative services to managed care organizations and providers that serve high-cost, complex member populations in the Medicare, Medicaid, and Dual-Eligible Market. ILS provides tailored integrated solutions aimed at improving health outcomes while rebalancing costs, addressing social determinants of health and connecting members with community-based resources.

Position Summary

Under the guidance of the SVP, Medical Economics, the Medical Economics Data Analyst is responsible for in-depth analysis to support Finance and operational functions to improve clinical, operational, and financial performance of the company's lines of business. This position will focus on monitoring unusual variances in performance, analyzing these variances, and packaging the analyses to communicate the results, thereby enabling pertinent areas to take appropriate action.

Essential Functions
  1. Validate, transform, and model health care claims, enrollment, and operational data to improve decision making, using statistical analysis to identify patterns, correlations, and actionable results.
  2. Work closely with business stakeholders and source system owners to research data anomalies and provide recommendations for resolutions.
  3. Collaborate with other functional areas such as Finance, Care Management, Clinical Services, Claims Processing, Health Plan Operations.
  4. Maintain detailed documentation, including data issues and resolution, methodology employed, decisions made, and reports delivered.
  5. Communicate data-driven insights and recommendations to internal stakeholders, including executive leadership, soliciting and incorporating feedback as appropriate.
  6. Perform other duties as required or assigned.
Education and Experience
  • Bachelor's degree in health informatics, finance, economics, actuarial services, or related field.
  • Three to five years of experience working with claims data, risk models, mathematical or actuarial analysis, preferably in the health insurance field.
Required Skills
  • Proficient in Microsoft Office Suite, with advanced skills in Microsoft Excel.
  • Ability to apply knowledge of mathematics, probability, statistics, principles of finance and business to calculate financial outcomes.
  • Professional attitude and appearance.
  • Solid written and verbal communication skills.
  • Ability to be resourceful and proactive when issues arise.
  • Excellent organizational skills and attention to detail.
  • Multitasking and time-management skills, with the ability to prioritize tasks.
EEO Statement

In compliance with the Drug-Free Workplace Act of 1988, Independent Living Systems has a longstanding commitment to provide a safe, quality-oriented, and productive work environment. Alcohol and drug abuse pose a threat to the health and safety of ILS employees and to the security of the company's equipment and facilities. For these reasons, ILS is committed to the elimination of drug and alcohol use and abuse in the workplace.

Independent Living Systems, LLC, and its subsidiaries, including FCC, provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, disability, ancestry, or any other characteristic protected by state, federal, or local law. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

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