Medical Economics Advisor

Found in: beBee jobs US - 1 week ago


Nashville, Tennessee, United States Selby Jennings Full time

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



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