Medical Economics Consultant

Company

Highmark Inc.

This job is responsible for the financial reporting of Highmark’s strategic cost of care savings program. The ideal candidate will be comfortable gathering financial data from multiple business partners, performing quality checks on the data, performing financial analysis on the data and creating the executive leadership financial report. The incumbent will have proven detailed technical and analytical experience with strong communication and influencing skills.

More specifically, the candidate will take ownership of delivering a high-quality financial report with key insights on the emerging program impact to the health plan. Someone with an eye for detail and a drive to continuously improve processes is preferred. Using data driven analytics, the ideal candidate will:
1) develop dashboards and reports showing total program impact to the health plan,
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.

• Required Bachelor's Degree in Business, Health, Economics, Mathematics/Actuarial Sciences or other related area
• Substitutions None
• Preferred Master's Degree in Business, Health, Economics, Mathematics/Actuarial Sciences or other related area

• Required 5 years of Medical Economics, Healthcare Analytics, Informatics and/or Actuarial Services in the health care payer sector
• Preferred Strong coding background (R, R Shiny, Python, SQL, etc.). Experience building dashboards in Tableau, Power BI, or R Shiny.

• Required None
• Preferred 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

Other then English:
None

0% - 25%

Position Type Hybrid or Remote - if you live within 50 miles of an office you are required to be onsite 3 days a week. T, W, Th. 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

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