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Senior Analyst, Health Economics

2 months ago

Doral, United States ChenMed Full time

The Senior Health Economics Analyst is responsible for identifying and delivering data-driven insights and analytical support to executive leadership of ChenMed. Success in the role will be achieved through the ability to leverage data and analytic skills to create business intelligence—identifying risks to be mitigated or opportunities to be seized. The incumbent serves as the primary medical cost analytics consultant to our Finance, Clinical, Operations, and Specialty Care leadership and will make data-driven strategy recommendations in the Medicare Advantage and healthcare industry. This senior-level analyst position has the opportunity for impact and advancement within the Finance organization and the broader enterprise. ESSENTIAL JOB DUTIES/RESPONSIBILITIES: Analyzes and interpret enrollment, revenue, and claims (utilization and unit cost) data to identify and solve business problems and continuously improve data-driven strategies and processes to improve financial results. Partners with finance and business leaders to create benchmarks to monitor medical cost trends and variances. Assists in the design and evaluation of company KPIs for potential replacement or evolution as the company grows. Prepares and analyze medical cost and leading indicator data to develop presentations for executive management. Interpret results and articulate actionable recommendations that maximize profitability and ensure financial targets are achieved. Tracks performance of medical cost Key Performance Indicators (KPIs) for assigned Divisions/Departments. Leverages data analytics and modeling to test, validate and track return of investment of existing and proposed medical cost strategies and initiatives. Works with Analytics and IT teams to validate data, enhance medical cost reports and tools, and help design new products for enterprise consumption. Builds strong and trusting relationships with leaders to support problem resolution and ensure overall awareness of medical cost issues and challenges. Supports finance in the annual and multi-year planning process including development of medical cost targets, key metrics, and projections. Analyzes emerging medical cost results and forecast the impact of those results on future periods (including identification and execution of actions to improve those results). Prepares ad-hoc analysis for claims and KPIs of medical costs for executive leadership. Develops a deep understanding of the economic impact of the components, drivers, and indicators of the ChenMed core model and external factors. Performs other duties as assigned and modified at manager’s discretion. KNOWLEDGE, SKILLS AND ABILITIES: Strong analytical, problem-solving, critical-thinking, communication, and relationship skills Effective organization skills with the ability to work in a very fast-paced, team-oriented environment with minimal supervision Ability to interpret the needs of the organization and communicate actionable insights through analytics Ability to develop presentations to drive action/impact Ability to model financial concepts of ROI, IRR, etc. Strong financial acumen, problem-solving and analytical skills with keen attention to detail and accuracy Ability to analyze multiple data sources to develop deep understanding of market dynamics, identify and prioritize opportunities, and spot trends Extensive knowledge of healthcare/medical economics data such as hospital/physician /ASC claims, utilization data, and healthcare industry coding systems ICD-10, CPT/HCPCS, Revenue Codes, MS/APR-DRGs and APCs Excellent communication skills across verbal, written, and presentation applications (Microsoft Word, PowerPoint, Excel, etc) Experience with Excel, Qlikview & SQL preferred Spoken and written fluency in English This job requires use and exercise of independent judgment EDUCATION AND EXPERIENCE CRITERIA: Bachelor’s degree: experience may substitute for education on a year-for-year basis above the minimum experience required Bachelor’s degree in Finance, Data Analytics or Economics and/or MBA preferred Minimum of four (4) years of related experience Experience in a Medicare Advantage, Hospital Systems and/or risk-based healthcare organization, preferred

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