Medical Economics Consultant

Company :
Highmark Inc. Job Description :

This job is responsible for using medical cost analytics to provide fact based strategic insights into emerging medical cost trends. Using large sets of data, the ideal candidate will create the story of medical cost trends in a way that is clear, concise and easily understandable. The incumbent will have proven detailed technical and analytical experience with strong communication and influencing skills.

More specifically, will engage with matrix partners to develop the medical cost analytics to determine the value of business solutions. Using data driven analytics, the ideal candidate will:
1) develop the value of the programs,
2) track the outcomes of the programs, and
3) provide strategic insight into areas of focus/opportunities.

• Provide strategic/tactical insights into emerging medical cost trends. Develop executive ready presentations explaining analytical findings in a clear concise manner.
• Proficiency to extract, summarize and analyze large datasets via SAS, SQL or other similar tools.
• Provide business areas with opportunity assessments of their strategic medical cost programs. Coordinate savings opportunity projections and post implementation savings measurements. Develop improved business case and savings estimate capabilities to enable more accurate and deeper projections.
• Leverage analytical experience and knowledge to drive independent medical cost analytics; develop areas of opportunity using a fact-based analysis, present medical cost analytics and insight into claim cost drivers to key business partners.
• Strong communication skills (verbal and executive quality presentations) to present clear, concise presentations of the detailed analytics.
• Work in a matrixed work environment. Partner with other departments in developing the full analytical story.
• Other duties as assigned or requested.

• Bachelor's Degree in Business, Health, Economics, Mathematics/Actuarial Sciences or other related area

• None

• Master's Degree in Business, Health, Economics, Mathematics/Actuarial Sciences or other related area

• 5 years of Medical Economics, Healthcare Analytics, Informatics and/or Actuarial Services in the health care payer sector

• Strong coding background (R, R Shiny, Python, SQL, etc.). Experience building dashboards in Tableau, Power BI, or R Shiny.

• None

• None

• Proven analytical ability to drive independent work and meet business timelines and outcomes.
• Strong Technical Data Skills (SAS / SQL, R, Tableau, Excel, etc.)
• Demonstrated ability to work with business partners in communicating outcomes, partnering on analytics, and developing new approaches to breaking down a strategic hypothesis.
• Experience in the healthcare Industry, with solid knowledge of emerging trends and challenges

None

0% - 25%

Office-Based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Rarely

Lifting: 25 to 50 pounds

Never

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This position adheres to the ethical and legal…