Sr Medical Economics Analyst

Join to apply for the Sr Medical Economics Analyst role at Better Health Group

Overview
Our mission is Better Health. Our passion is helping others.

What’s Your Why?

• Are you looking for a career opportunity that will help you grow personally and professionally?
• Do you have a passion for helping others achieve Better Health?
• Are you ready to join a growing team that shares your mission?

Why Join Our Team: At Better Health Group, it’s our commitment, our passion, and our culture that sets us apart. Our Team Members make a difference each and every day! They support our providers and payors, ensuring they have the necessary tools and resources to always deliver best-in-class healthcare experiences for our patients. We don’t just talk the talk - we believe in it and live by it.

Be part of a team that shares your passion and drive, and start living your purpose at Better Health Group.
Responsibilities
Position Objective: The Senior Medical Economics Analyst plays a critical role in analyzing and optimizing medical cost trends, healthcare utilization, and financial performance within value-based care models. This position combines advanced data analytics, financial modeling, and strategic evaluation to provide actionable insights that support payors, providers, and executive leadership. Collaborating with Provider Operations and key stakeholders, the Senior Analyst develops reports, dashboards, and analytical frameworks to drive cost containment strategies, resource optimization, and operational efficiency.

This high-impact role requires strong analytical skills, programming expertise, and a deep understanding of Medicare Advantage, healthcare economics, and regulatory compliance. Contributes to strategic decision-making by identifying opportunities for financial improvement while ensuring alignment with organizational and CMS guidelines.
Responsibilities Include And Are Not Limited To

• Extracts, manages, and analyzes healthcare claims, eligibility, and pharmacy data to identify trends, insights, and outliers using industry-standard metrics such as PMPM, Utilization per 1000, and Unit Cost.
• Develops and implements financial models and analytical frameworks to evaluate medical cost trends, healthcare utilization patterns, and overall service fund performance.
• Conducts in-depth research and analysis of complex healthcare data to support cost containment, efficiency improvements, and strategic decision-making.
• Utilizes advanced programming and data analytics tools to explore, examine, and interpret large datasets for business intelligence and financial forecasting.
• Identifies opportunities for cost savings and optimization within healthcare operations while ensuring the quality of care is maintained.
• Analyzes provider contracts, payer agreements, and vendor partnerships to assess financial impact and alignment with organizational objectives.
• Collaborates with medical management teams to analyze utilization patterns and recommend resource allocation improvements.
• Engages with health plans, regulatory agencies, and internal stakeholders to align data reporting requirements and compliance with industry regulations.
• Presents complex financial and operational analysis to executive leadership, offering actionable insights to drive strategic initiatives.
• Reviews and maps health plan and regulatory data files for extraction, transformation, and integration into standardized data structures.

Position Requirements/Skills

• Bachelor’s Degree in Business, Finance, Computer Science, Engineering, Economics or related field preferred.
• 4+ years of professional experience in claims-based healthcare analytics with a payer, provider, clinical vendor, managed care, or related healthcare consulting entity.
• 2+ years of professional experience in Medicare / Medicare Advantage.
• Experience working with a health plan or managed service organization.
• Advanced or higher proficiency in Microsoft Excel.
• Advanced or higher proficiency in Power Query, Power Pivot or Power Bi.
• Advanced or higher proficiency in SQL or database/statistical programming languages.
• Exceptionally strong analytical abilities, with a track record of identifying insights from…