Data Analyst IV Medical Economics

Job Summary

We are seeking a Data Analyst IV responsible for analytic data needs of the business unit in the health care industry. The ideal candidate will be required to handle complex data projects and act as a lead for other Data Analysts. We are looking for a very specific type of candidate as this company is expanding their Medical Economics team. They have had success with candidates who have some actuarial experience as well and with some consultants who have worked in managed care in the medical economics space.

Location:

Remote. This position will support mostly CST/EST - if this candidate is PST, they will be expected to work 6-3p PST (8-5 CST or 9-6 EST).

Yes! 8% targeted bonus

• Provide advanced analytical support for business operations in all or some of the following areas: claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting
• Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources
• Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management
• Develop reports and deliverables and make recommendations to management
• Model data using MS Excel, Access, SQL, and/or other data ware house analytical tools
• Assist management in driving business decisions based on data
• Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis
• Assist with training and mentoring other Data Analysts
• Assist with determining work load and related activities for other Data Analysts
• Performs other duties as assigned
• Complies with all policies and standards

• Bachelors degree in Business, economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance or related field or equivalent experience. Master's degree preferred. 5+ years of experience working with large databases, data verification, and data management

• Experience with Medicare, Medicaid and Marketplace analytics
• Strong SQL skills, including the ability to write and understand complex queries, SELECT statements, and multiple types of JOINs.
• Advanced Excel skills, including:
  Pivot Tables Power Query VLOOKUP / XLOOKUP Averages, aggregations, formatting Creating and nesting formulas to build metrics and perform financial modeling Power BI experience, with familiarity in DAX and Power Pivot.
• Experience with financial analytics tools and basic financial modeling/sizing
• Strong understanding of payment methodologies, including DRG pricing, APC, and EAPG payment methodologies

• Python and R
• Collaborate with cross-functional teams to evaluate QAI (Quality and Affordability Initiatives), MLR (Medical Loss Ratio) targets, and related key performance indicators (KPIs)

5+ years of experience

Managed Care Analytics - payment methodologies - Medical Economics (Healthcare)