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Senior Health Economics Analyst

5 months ago

Plymouth Meeting, United States ProgenyHealth LLC Full time
Job DescriptionJob DescriptionDescription: The Senior Health Economics Analyst will collaborate with colleagues to develop innovative analytics solutions to drive outcomes and improve business processes. Additionally, this role will assist Senior Leadership teams in interpreting and understanding the utilization of healthcare services and medical spend within our care management programs. The individual will also provide key technical support for all healthcare claims analysis reporting requests, reviews, and metrics.

This is a highly visible position working with both internal and external stakeholders. The ideal candidate will have in-depth knowledge of the healthcare industry, technical experience analyzing large claims datasets with MS SQL and statistical packages such as R, and experience utilizing the data visualization tool Tableau.

Requirements:

Responsibilities will include:

  • Perform healthcare claims analysis for the purpose of annual program evaluation and other ad-hoc reports.
  • Analyze health care spend and utilization to identify key trend drivers, perform root cause analyses and data mining to evaluate medical cost savings opportunities
  • Develop, measure, and communicate pre and post-performance measures and perform ROI analyses for new and existing clients.
  • Build and execute recurring reports on a quarterly and annual basis, validating and communicating results to various stakeholders.
  • Analyze clinical (EMR) and claims data to produce summary analyses and reports when needed.
  • Prepare client facing summaries in the form of a presentation using business intelligence tools to help highlight program performance and areas of concern.
  • Assist in our data governance and data management processes.
  • Interface with clients to understand their payment methodologies, governmental requirements, etc. to provide pre-program data analysis using industry standards.
  • Assist with ad-hoc reporting and analytical efforts from our health services and finance departments.

Qualifications

  • A minimum of 7 years progressive experience generating and analyzing claims data for population management within a payer environment is required.
  • Proficiency in SQL and Data Visualization Tools (i.e. Tableau, Power BI, R, etc.) required.
  • A minimum of 2 years of PL-SQL or T-SQL and 2 years of analyzing data and presenting outcomes to internal stakeholders required.
  • Experience in healthcare and/or disease management industry preferred.
  • Bachelor’s degree required.
  • Adept at reviewing healthcare data, including paid claims data and EMR records.
  • Must be a strong communicator, both written and verbal, and able to speak and write in English fluently.
  • Ability to interact effectively with different business units, team members, and external clients at all levels.
  • Ability to deal with ambiguity and drive results.
  • Desire to make an impact, manage multiple tasks, and shift priorities quickly.
  • Must be self-motivated and willing to learn multiple tasks.
  • Must be well organized and able to prioritize tasks.
  • Must demonstrate accuracy in writing and documentation.

Company Description/Benefits

ProgenyHealth empowers our health plan and employer partners to change the trajectory of maternal and infant health outcomes across America. Our end-to-end maternal and infant care management solution helps ensure the best possible outcomes for every expecting mother we touch. Our wholly integrated solution builds a network of support for an uninterrupted continuum of care from prenatal health, through any resultant NICU stay, and all the way to one full year of life. We help overcome systemic barriers to support healthier pregnancies and healthier starts to life for all moms and babies, one family at a time.


Some of the benefits we offer our team are:

  • Paid Time Off
  • Paid Parental Leave
  • Medical, dental, vision benefits
  • 401K with company match
  • Short- and Long-Term Disability
  • Group Life Insurance
  • Tuition reimbursement
  • Professional development opportunities
  • Business Casual work environment
ProgenyHealth positively recruits people from diverse backgrounds, including individuals with disabilities - if you need an accommodation to interview, please contact us by email: careers@progenyhealth.com


Equal Opportunity Employer, including individuals with disabilities and veterans.