Sr. Medical Economic Analyst

Employment Status:

Full time

Day (United States of America)

213 S Jefferson St - Roanoke

R162229 Sr. Medical Economic Analyst (Open)

The Senior Medical Economist Analyst works closely with the Strategic Payment Relationships leadership to capture, integrate, transform, interpret and present healthcare data, in support of the best possible decision making and outcomes on a variety of strategic initiatives. They will lead payer analytics, payment modeling and reporting, in support of successful contract negotiations and payer performance monitoring.

Onsite is preferred, hybrid or remote work option is available. Candidates residing in the following states can be considered for remote work:
Alabama, Florida, Georgia, Arkansas, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, West Virginia, and Virginia.

• Leads modeling of commercial and government payment methodologies for all types of healthcare services: hospital, physician, ambulatory, home health, hospice, etc.
• Transforms data into analytical insights, to inform decisions for the Contracting team and Carilion executive stakeholders.
• Effectively communicates analysis to be consumed by department and executive leadership.
• Demonstrates expert knowledge of both commercial and governmental payers for modeling and analyzing contract proposals with a variety of reimbursement methodologies: case rates, DRG, fee schedules, stoploss and other contract terms.
• Leverages hospital (Fin Thrive) and physician (Experian MPV) claim modeling systems for enhanced payer contract analytics.
• Continuously learns and adapts to a constantly changing reimbursement environment.
• Completes extensive and complex financial and operational analyses, modeling of managed care contracts and proposals, analyze fee schedules, and determine contract performance and compliance.
• Extracts, analyzes, and synthesizes data from various sources to identify risks and opportunities.

Education: Bachelor’s degree in computer science, accounting, business, data science, statistics, or related field. 4 years of relevant experience may be considered in lieu of degree.

Experience: Minimum 4 years of complex data analysis and data manipulation experience.

Licensure, Certification, and/or Registration: Specific certification(s) may be required as determined by the department. Life Support: N/A

Other

Minimum Qualifications:

High proficiency with computers, operating systems, relational databases, and analytical and statistical software. Demonstrated skills in research design, statistical analysis, and statistical process control methodology. Strong analytical reasoning, problem-solving capability, written and verbal communication skills. Ability to manage competing deadlines, prioritize tasks, and maintain accuracy while working with large volumes of data. Ability to handle confidential and sensitive information with discretion;

occasional travel may be required.

This job description is intended to be a representative summary of the major responsibilities and accountabilities performed by incumbents in this role. Incumbents may be required to perform job-related tasks other than those specifically presented in this description.

Compensation Range:

$76,689.60 - $

Employee pay is based on a variety of factors, including qualifications, credentials, education, and prior work experience. The compensation range does not include benefits or pension plan.

Recruiter:

MARK MISKOVIC

Recruiter Email:

mamiskovic

For more information, contact the HR Service Center at

Carilion Clinic is an Equal Opportunity

Employer:

We provide equal employment opportunities to all employees and applicants without regard to race, color, religion, sex, national origin, age (40 or older), disability, genetic information, or veterans status. Carilion is a Drug-Free Workplace. For more information or for individuals with disabilities needing special assistance with our online application process contact Carilion HR Service Center at , 8:00 a.m. to 4:30 p.m., Monday through Friday.

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