Healthcare Medical Economics Analyst II

Job Summary:

The Healthcare Analyst II is responsible for analyzing healthcare utilization and costs to identify patterns, variation, and outliers. Identify and quantify opportunities to reduce medical costs and understand their related financial outcomes.

Essential Functions:

• Analyze healthcare utilization to identify patterns, variation, and outliers.
• Identify and quantify opportunities to reduce medical costs within the markets
• Evaluate the effectiveness of medical cost reduction initiatives.
• Support tracking and reporting of medical cost reduction initiatives.
• Work with Actuarial and Market Finance teams to accurately accrue and forecast the savings impacts of medical cost reduction initiatives.
• Understand the measurement of financial outcomes related to medical cost reduction initiatives.
• Develop tools to efficiently compare market performance across and within products.
• Support reporting on realized savings using sound analytical and financial techniques
• Work collaboratively with cross functional teams, including department leaders and operators, to understand/track operational details of medical cost reduction initiatives.
• Support the intake, prioritization and coordinated execution of ad-hoc analytics requests from departments across the organization
• Perform any other job duties as requested

Education and Experience:

• Bachelor’s Degree or equivalent years of relevant work experience is required
• Minimum of two (2) years of experience in healthcare analytics is required
• Managed care experience is strongly preferred.
• Experience with financial analysis is required, health plan preferred.

Competencies, Knowledge and Skills:

• Knowledge of healthcare data, including medical and pharmacy claims, EMR data, HIE data, UM data and demographic data
• Knowledge of Medicaid, Medicare and other government sponsored healthcare programs is preferred
• Proficient in with Excel, Word and PowerPoint
• Proficient with Transact-SQL or SAS or Microsoft Power BI or Tableau
• Proficient in Financial reporting concepts
• Ability to organize data in a way that facilitates inferences, conclusions and decisions

Compensation Range:

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Organization Level Competencies

• Fostering a Collaborative Workplace Culture

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.