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Healthcare Economics Consultant

2 months ago

Washington, United States CINQCARE Full time
Job DescriptionJob Description

About CINQCARE

CINQCARE is a provider-led, community-based comprehensive health and care partner. Our purpose is to every day improve the health and well-being of those who need care the most. We do that by removing barriers to health and well-being and providing care in the community and as close to the home, including in-home, whenever possible.

At CINQCARE, we know that race and culture matter for effective healthcare outcomes. That is why we take race, culture and environment into account in our care delivery. We are building a culture of care, which starts with understanding our patients, their needs and their care plans.

At CINQCARE, we also know that effective care is about local physicians, local nurses, local caregivers, local services, personal care, and infrastructure that serve the needs of people, not the symptoms of illness. Providing services in the home whenever possible is key to our approach. We aim to deliver better outcomes for people and the communities in which they live.

CINQCARE’s purpose is to every day improve the health and well-being of those who need us the most – with a deep commitment to Black and Brown populations – in their homes and communities. It requires the collaborative and cohesive effort of numerous individuals across all levels of the organization to deliver on this purpose. Once community at a time, we are determined to help create a world where health and care isn’t a burden. Because we believe providing care is a privilege – one we are grateful to earn. That’s why CINQCARE has built a different way to care.

CINQCARE was born different. We were created to be on call to answer the call every day. We are driven to deliver health, care and well-being to those who need us the most and to relentlessly support our team members on the front lines. That’s our calling and if it’s yours we hope you’ll join us.

About You

The Healthcare Economic Consultant should have the following qualifications:

  • Education: Bachelor’s degree in Math, Statistics, Computer Science, Finance, or a related field. Masters degree preferred.
  • Experience:
    • 5+ years of experience working as a consultant in the healthcare industry with medical claims, membership, and provider data.
    • Experience with Structured Query Language (SQL)
    • Expertise in MS Excel, with proficiency using formulas, PivotTables, linked worksheets, graphing and other reporting and presentation features.
    • Experience in data mining, statistical analysis, and data transformation / manipulation
    • Proven highly self-motivated and directed with keen attention to detail.
    • Demonstrated ability to analyze data and apply investigative skills in resolving issues.
    • Demonstrated ability to work on multiple projects simultaneously with minimal supervision.
    • Demonstrated ability to multi-task in a fast-paced environment and quickly adapt to changes in both technology and business environments.
    • Demonstrated ability to produce clear, written progress notes and supporting documentation.
  • Entrepreneurial: CINQCARE seeks to fix gaps that have persisted for generations in the delivery of care to Black and Brown populations. This position is accountable for ensuring CINQCARE is positioned to innovatively deliver on its promise.
  • Communication: Excellent verbal, written communication, presentation, and strong organizational skills; ability to clearly articulate and present concepts and models in an accessible manner to CINQCARE’s team, investors, partners, and other stakeholders.
  • Relationships: Ability to build and effectively manage relationships with their team, business leaders and external constituents.
  • Culture: Good judgement, impeccable ethics, and a strong team player; desire to succeed and grow in a fast-paced, demanding, and entrepreneurial Company

About the Job

The Healthcare Economic Consultant reports to the SVP Healthcare Economics & Analytics with accountability for providing strategy, judgment, organization, and evidenced-based analysis to influence decisions, and directly to meet CINQCARE requirements. The candidate should embody CINQCARE’s core values, including, Trusted, Empathetic, Committed, Humble, Creative and Community-Minded.

The Healthcare Economic Consultant will have the following responsibilities:

  • Lead the development and adaptation of medico-economic models (cost-effectiveness, cost-utility, and budget impact models).
  • Write SQL queries, create end-user reports, and apply varying analytical techniques to solve specific business problems.
  • Provide input and consultative support to Medical Directors, Finance Leaders, and Business Unit leaders on trend and cost of care issues.
  • Extracts, aggregates, and QAs applicable data for measurement purposes
  • Identify, monitors, and analyze principal health care cost drivers, by market segment and/or by provider, including utilization, referral patterns, and reimbursement rates.
  • Develop comprehensive understanding of programs being measured.
  • Apply strong critical thinking skills to anticipate questions from key stakeholders and consider all aspects of an analysis before completion.
  • Assist with client management and attend external meetings.
  • Assist with project management and project delivery, including oral presentations.
  • Analyze and present data related to medical trends. Summarize performance using appropriate analytics and tools. Develop business performance reports using claims data that tells the drivers behind medical trends. Create and publish standard and ad hoc reports.
  • Develop an in-depth understanding of line of business concerns to facilitate novel ways of exploring and explaining trends.
  • Build new and modify existing complex models to create predictive impact decision making tools; Perform healthcare cost analysis to identify strategies to control costs.
  • Project cost increases in medical services by using analytic techniques for PMPM trending via multiple variable analysis.
  • Identify cost of care savings opportunities by analyzing practice patterns in relation to office visits, referral practices, and specialty care procedures.
  • Recommend policy changes and claim system changes to pursue cost savings.
  • Review results post-implementation to ensure projected cost savings are realized and recommend modifications as applicable.
  • Participate on project teams involved with enterprise-wide initiatives.
  • Acts as a source of direction, training, and guidance for less experienced staff.
  • And of course, perform other job-related duties as assigned.

The Healthcare Economic Consultant will also have the following duties:

  • Strategy: The Healthcare Economic Consultant will effect the business strategy and roadmap to: (1) improve outcomes for CINQCARE Family Members; (2) enhance the efficacy of other CINQCARE. business divisions; and (3) develop and deliver external market opportunities for CINQCARE products and services. In establishing the business strategy, the Healthcare Economic Consultant will define and innovate sustainable revenue models to drive profitability of the Company.
  • Collaboration: The Healthcare Economic Consultant will ensure that CINQCARE’s capabilities form a cohesive offering, including by working closely with other business divisions to learn their needs, internalize their knowledge, and define solutions to achieve the business objectives of CINQCARE.
  • Knowledge: The Healthcare Economic Consultant will provide subject matter expertise, including developing materials to support the presentation of the conceptual approach for the business opportunity to key decision makers.
  • Culture: The Healthcare Economic Consultant is accountable for creating a productive, collaborative, safe and inclusive work environment for their team and as part of the larger Company.

Working Environment and Physical Requirements

The working environment and physical requirements of the job for the Healthcare Economic Consultant include:

This position requires on-site work. The job is performed indoors in a traditional office setting with conditioned air, artificial light, and an open work space.

In this position you will need an ability to communicate customers, vendors, management, and other co-workers in person and over devices, sometimes with people who are agitated. Regular use of the telephone and e-mail for communication is essential. Sitting for extended periods is common. Must be able to receive ordinary information and t

o prepare or inspect documents. Lifting of up to 30 lbs. occasionally may be required. Good manual dexterity for the use of common office equipment such as computer terminals, calculator, copiers, and FAX machines. Good reasoning ability is important. Able to understand and utilize management reports, memos, and other documents to conduct business.