Senior Analyst, Cost of Care - Hybrid NY

Scope of Responsibilities

• Develop actionable analytic tools to monitor medical cost and utilization trends, provide concise insight into root‑cause drivers, and collaborate with the team to identify remediation opportunities.
• Develop savings analyses for Medical Economics cost‑trend reduction initiatives, applying financial modeling expertise and independent judgment to determine best valuation methods.
• Prioritize cost mitigation activities across business areas.
• Provide actionable, data‑driven analysis to Finance, Claims, Pharmacy, Payment Integrity, Medical Management, Network, and other departments to enable critical decision‑making.
• Evaluate data to identify and root‑cause payment integrity issues and lead cross‑functional problem‑solving efforts.
• Develop interactive financial models to evaluate the impact of provider reimbursement changes.
• Support all provider settlement and data reconciliation activities.
• Maintain tools that define profitability dashboards by product.
• Stay abreast of New York Medicaid and Medicare reforms, reimbursement methodologies, and their impact on Healthfirst and its owner hospital performance.
• Perform ad hoc analyses.

• Bachelor’s Degree from an accredited institution.
• At least three (3) years of healthcare analytics experience, including at least two (2) years in contract evaluation, medical economics, medical cost containment, actuarial, or healthcare reimbursement model design.
• Extensive knowledge of managed care financial metrics (PMPM, util/k, cost/unit).
• Experience utilizing healthcare claims data to uncover valuable insights to improve financial performance.
• Experience with government and proprietary payor reimbursement methodologies and unit cost management.
• Experience with SAS or SQL (creates queries and data manipulation).
• Extensive experience with Microsoft Excel (building financial models, utilizing pivot tables, VLOOKUP, INDEX/MATCH, and calculated fields).
• Claims experience, including root‑cause analysis and system set‑up.
• Ability to work with large data sets.
• Strong written and verbal communication skills.
• Resourceful and creative in solving complex issues and collaborating with others to achieve solutions.
• Ability to manage projects and project plans within stated timelines.

• Expertise in key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee‑for‑Service), DRGs, APGs, APCs, and other payment mechanisms.
• Understanding of value‑based risk arrangements.
• Experience using Tableau and Python.
• Experience mentoring other team members.

Onsite at 100 Church Street, New York, NY 10007 on Tuesdays, Wednesdays, and Thursdays.

Greater New York City Area: $83,100 – $120,360
Other Approved Locations: $73,400 – $109,225 (range is indicative and may vary based on experience, education, licenses, and certifications).

Healthfirst offers a full range of benefits, including medical, dental, and vision coverage, incentive and recognition programs, life insurance, and 401(k) contributions (subject to eligibility requirements).

HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender identity, military status, veteran status, citizenship or immigration status. HF Management Services, LLC shall not discriminate against a disabled employee or applicant for any position for which the applicant is otherwise qualified.

If you have a disability under the Americans with Disabilities Act or a similar law and need a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers or calling 212‑519‑1798. Please include a description of the accommodation you are requesting and a description of the position for which you are applying.