Medicare Products Analyst

Medicare Products Analyst

Supports Medicare product management by evaluating data trend experience, creating data analytics on supplemental benefits for the Medicare Advantage. Evaluates all benefits, including supplemental, SSBCI, and VBID. Supports the development and execution of Medicare Advantage product strategy and corresponding benefits. Builds PBPs, balancing market competitiveness and financial viability with product and market leaders. Supports analysis of market dynamics and creation of data-driven recommendations for market leadership to facilitate strategic decision-making.

Analyzes market trends; supports product assessment, CMS bid cycle design, and regulatory document development (EOC, ANOC, SOB).

Responsibilities:

• Utilizes data mining and analytical expertise to understand large data sets. Develops and implements data analytics and reporting for Medicare Advantage Supplemental Benefits. Utilizes advanced statistical methodology including conjoint, max diff, regression analysis to provide data-driven conclusions.
• Collaborates with other team members and market teams to develop and support product portfolios, benefits, and programs that drive membership growth, improve member satisfaction, enhance revenue & profitability.
• Plays a key role in the annual CMS Bid development in partnership with the Product Managers, ensuring the products are competitive, compliant, accurate, and positioned to achieve plan goals.
• Leads and executes complex data-related analytical projects to drive business decisions and efficiencies; ensures timely and accurate reporting, corrects issues and errors, implements best practices. Provides clear and precise summary documents and reports for all levels of management.
• Develops and presents in-depth analysis on industry wide Medicare Advantage formularies. Creates modeling, develops analysis, and presents insights to management. Collaborates with Product Management and Pharmacy to evaluate formulary analysis for product benefit design changes.
• Evaluates membership and utilization by plan and acquisition channel for Medicare Advantage and Medicare Supplement product lines. Performs data analysis of trend experience used by management in making benefit decisions and changes for pricing and annual bid submission.
• Act as a key member of the regulatory document development team to ensure accurate Evidence of Coverage (EOC), Annual Notice of Change (ANOC), Summary of Benefits (SOB), etc.
• Gather and analyze quantitative and qualitative data and research on existing and potential markets, as well as support the creation of market assessment deliverables.
• Performs other duties as assigned.

Qualifications:

• Bachelor's degree in Business, Healthcare or other quantitative field, or equivalent combination of education and experience.
• 3 years' experience in statistical analysis or data analysis.
• 2 years are in a Medicare Advantage organization preferred.

• Demonstrated ability to pull large data sets and perform data manipulations/analysis.
• Knowledge of various data mining, reporting, and reconciliation tools and methodologies.
• Highly proficient in Microsoft Office, SAS, SQL, Tableau.