Advisor, Medical Economics

1 week ago

Nashville, United States ArchWell Health Full time
Advisor, Medical Economics Nashville, TN, USA * Virtual Req #12127 Tuesday, December 17, 2024

ArchWell Health is a new, innovative healthcare provider devoted to improving the lives of our senior members. We deliver best-in-class care at comfortable, accessible neighborhood clinics where seniors can feel at home and become part of a vibrant, wellness-focused community. Our members experience greater continuity of care, as well as the comfort of knowing they will be treated with respect by people who genuinely care about them, their families, and their communities.

Job Summary:

The Advisor, Medical Economics will play a key role in supporting analytical needs across ArchWell Health's Operations, Clinical, and Finance teams. This will be a colleague who is motivated by the challenge of answering complex medical economics questions using a variety of data sources. This is a fast-paced position that will enable high-quality personal development and growth.

Duties/Responsibilities:

  • Identify, monitor, and analyze principal health care cost drivers, by market segment and/or by provider, including utilization and referral patterns and reimbursement rates
  • Research healthcare delivery topics, analyze data, present results, and recommend solutions to address business challenges by applying knowledge of medical claims analysis, critical-thinking skills, and healthcare experience/expertise
  • Analyze claims, membership, and prior authorization data to identify early signs of trends or other issues related to medical care costs and quality of care
  • Provides actuarial support for Medicare Advantage plans by identifying trends and profitability drivers utilizing sound statistical methods.
  • Utilizes experience with HCCs and RAFs to forecast revenue projections
  • Structure analytical results in an organized, visual manner to tell a meaningful, actionable story
  • Work with Engineering team to source data, determine its credibility and usability, create end-user reports, and apply varying analytical techniques to solve specific business problems
  • Perform ad-hoc requests from key stakeholders
  • Interpret contractual language with a clear understanding of business rules and reporting requirements
  • Execute other duties and special projects as needed, focusing on knowledge and skills development

Required Skills/Abilities:

  • You enjoy independent research and presenting solutions to complex problems
  • You work both collaboratively and independently to complete complex analyses, leading to actionable strategic and financial business decisions
  • You apply strong critical thinking skills to anticipate questions from key stakeholders and consider all aspects of an analysis before completion
  • You exhibit initiative in exploring and discovering opportunities to improve company performance through data analysis
  • You establish trusting, professional relationships with internal, senior stakeholders

Education and Experience:

  • Bachelor's degree in Applied Math, Statistics, Actuarial Science, Economics, or a related field required
  • 4+ years of prior experience as an analyst with a health plan, ACO, RBE, or consulting firm focused on health economics
  • Expertise in MS Excel, including proficiency using formulas, PivotTables, PowerBI, graphing and other reporting and presentation features
  • Experience working with internal groups, including IT, to procure necessary datasets preferred
  • Experience in data mining working with large data repositories and/or relational databases with SQL experience strongly preferred
  • Experience creating product trend analyses using statistically valid methodologies

ArchWell Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected classification.

Other details
  • Job Family Operations
  • Pay Type Salary
Apply Now Share this job:

  • Advisor, Medical Economics

    1 week ago

    Nashville, United States ArchWell Health Full time

    Advisor, Medical Economics Nashville, TN, USA * Virtual Req #12127 Sunday, November 17, 2024 ArchWell Health is a new, innovative healthcare provider devoted to...

  • Medical Economics Advisor

    1 week ago

    Nashville, United States ArchWell Health Full time

    ArchWell Health is a new, innovative healthcare provider devoted to improving the lives of our senior members. We deliver best-in-class care at comfortable, accessible neighborhood clinics where seniors can feel at home and become part of a vibrant, wellness-focused community. Our members experience greater continuity of care, as well as the comfort of...

  • Medical Economics Advisor

    1 week ago

    Nashville, United States ArchWell Health Full time

    ArchWell Health is a new, innovative healthcare provider devoted to improving the lives of our senior members. We deliver best-in-class care at comfortable, accessible neighborhood clinics where seniors can feel at home and become part of a vibrant, wellness-focused community. Our members experience greater continuity of care, as well as the comfort of...

  • Call Center Sales Advisor

    2 weeks ago

    Nashville, United States USHA Full time

    Call Center Sales Advisor We're Growing: Our clients are looking for viable alternatives to their current benefit programs and as a result of current economic conditions, the demand for our products and services has never been higher! Our Call Center Sales Advisors can mak...

  • Call Center Sales Advisor

    3 weeks ago

    Nashville, United States USHA Full time

    Call Center Sales AdvisorInterested in this role You can find all the relevant information in the description below.We're Growing:Our clients are looking for viable alternatives to their current benefit programs and as a result of current economic conditions, the demand for our products and services has never been higher! Our Call Center Sales Advisors can...

  • Call Center Sales Advisor

    5 days ago

    Nashville, United States USHA Full time

    Call Center Sales Advisor We're Growing: Our clients are looking for viable alternatives to their current benefit programs and as a result of current economic conditions, the demand for our products and services has never been higher! Our Call Center Sales Advisors can make a real difference in people's lives. You'll work directly with Americas...

  • Customer Support Advisor

    4 weeks ago

    Nashville, United States McCoy Construction & Forestry Full time

    McCoy Construction & Forestry, a John Deere dealership group with 25 locations across the Midwest and East South Central Regions, has an opening for a Customer Support Advisor.The Customer Support Advisor (CSA) promotes and increases parts and service sales by establishing promising business relationships with existing as well as prospective customers with...

  • Customer Support Advisor.

    6 hours ago

    Nashville, United States McCoy Construction & Forestry Inc Full time

    McCoy Construction & Forestry, a John Deere dealership group with 25 locations across the Midwest and East South Central Regions, has an opening for a Customer Support Advisor. The Customer Support Advisor (CSA) promotes and increases parts and service sales by establishing promising business relationships with existing as well as prospective customers with...

  • Advisor, Market Enablement

    1 week ago

    Nashville, United States ArchWell Health Full time

    Advisor, Market Enablement Nashville, TN, USA * Virtual Req #12251 Monday, December 9, 2024 ArchWell Health is a new, innovative healthcare provider devoted to...

  • Customer Support Advisor.

    2 days ago

    Nashville, United States McCoy Construction & Forestry Full time

    McCoy Construction & Forestry, a John Deere dealership group with 25 locations across the Midwest and East South Central Regions, has an opening for a Customer Support Advisor.The Customer Support Advisor (CSA) promotes and increases parts and service sales by establishing promising business relationships with existing as well as prospective customers with...

  • Senior Investment Advisor

    2 weeks ago

    Nashville, Tennessee, United States PNC Financial Services Group Full time

    Job OverviewAt PNC Financial Services Group, our team is united in delivering exceptional customer experiences. As a Senior Investment Advisor, you will be based in a bank branch and work collaboratively with colleagues to manage an assigned book of business. Your expertise will focus on helping clients achieve their savings, investing, and retirement goals...

  • Medical Faculty Opportunity in Nashville

    3 weeks ago

    Nashville, Tennessee, United States TriStar Southern Hills Medical Center Full time

    We are seeking a Family Medicine physician to join our core faculty for a community-based GME program in Nashville, TN.About the PositionThe ideal candidate will be board certified by the ABMS in family medicine, licensed to practice in Tennessee or able to obtain licensure, and have graduate medical teaching experience. A strong commitment to providing...

  • Medical Director Opportunity in Pediatric Care

    2 hours ago

    Nashville, Tennessee, United States Adaptive Medical Partners Full time

    Adaptive Medical Partners is seeking a dedicated board-certified pediatrician to join our esteemed team in Tennessee. With a strong focus on quality care, we offer a unique opportunity for a motivated professional to make a meaningful impact in the lives of our patients.We are proud to offer a highly competitive compensation package, including an estimated...

  • Training and Development Advisor II

    2 weeks ago

    Nashville, United States Kelly Full time

    Job DescriptionFinding a job that fits your lifestyle isn’t always easy. That’s where Kelly® comes in. We’re seeking a Training and Development Advisor II to work at a multinational energy transportation company in Nashville, TN. Sounds good? Take a closer look below. We’re here to help you find something great that works for you—so you...

  • IT Project Management Senior Advisor

    2 months ago

    Nashville, United States The Cigna Group Full time

    The job profile for this position is IT Project Management Senior Advisor, which is a Band 4 Senior Contributor Career Track Role. We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we...

  • Client Relationship Financial Advisor

    3 weeks ago

    Nashville, Tennessee, United States First Horizon Bank Full time

    Job OverviewWe are seeking a skilled Client Relationship Financial Advisor to join our team at First Horizon Bank. As a key contact for personalized banking and advice, you will work closely with clients to understand their financial goals and objectives.Key Responsibilities:Provide exceptional customer service to deepen client relationshipsUtilize product...

  • Wealth Management Consultant for Private Banking

    2 weeks ago

    Nashville, Tennessee, United States Fifth Third Bank Full time

    Wealth Management Advisor II Job DescriptionFifth Third Bank is seeking a highly skilled Wealth Management Advisor II to join our team. This role will be based in Nashville, Tennessee.About the RoleThis position requires a minimum of eight (8) years of successful sales/client service experience in financial services industry. The ideal candidate will have a...

  • Tennessee Department of Treasury | Investment Stewardship Manager | nashville, tn

    4 weeks ago

    nashville, United States Tennessee Department of Treasury Full time

    The Tennessee Department of Treasury impacts the lives of Tennesseans every day. Treasury is responsible for many of the financial operations of state government, including managing more than $100 billion in assets through its various investment programs. We administer and invest the State’s Retirement Program, RetireReadyTN, which combines the state...

  • Investment Stewardship Manager

    4 weeks ago

    Nashville, United States Tennessee Department of Treasury Full time

    The Tennessee Department of Treasury impacts the lives of Tennesseans every day. Treasury is responsible for many of the financial operations of state government, including managing more than $100 billion in assets through its various investment programs. We administer and invest the State’s Retirement Program, RetireReadyTN, which combines the state...

  • Tennessee Department of Treasury | Investment Stewardship Manager | nashville, tn

    4 weeks ago

    nashville, United States Tennessee Department of Treasury Full time

    The Tennessee Department of Treasury impacts the lives of Tennesseans every day. Treasury is responsible for many of the financial operations of state government, including managing more than $100 billion in assets through its various investment programs. We administer and invest the State’s Retirement Program, RetireReadyTN, which combines the state...