Job Description

Data Analyst III Medical Economics

Location : Remote

This position will support mostly CST/EST stakeholders - if this candidate is PST, they will be expected to work 6-3p PST (8-5 CST or 9-6 EST) REMOTE USA (please no HI or AK at this time due to time zone)

Additional variable compensation: 8% targeted bonus Please note that the MAX comp will be $95k

Position Purpose: Analyze integrated and extensive datasets to extract value, which directly impacts and influences business decisions. Work collaboratively with key business stakeholders to identify areas of value, develop solutions, and deliver insights to reduce overall cost of care for members and improve their clinical outcomes.

• Interpret and analyze data from multiple sources including claims, provider, member, and encounters data. Identify and assess the business impact of trends
• Develop, maintain, and troubleshoot complex scripts and reports developed using SQL, Microsoft Excel, or other analytics tools
• Contribute to the planning and execution of large-scale projects with limited direction from leadership
• Assist in the design, testing, and implementation of process enhancements and identify opportunities for automation
• Identify and perform root-cause analysis of data irregularities and present findings and proposed solutions to leadership and/or customers
• Manage multiple, variable tasks and data review processes with limited supervision within targeted timelines and thrive in a demanding, quickly changing environment
• Demonstrate a sense of ownership over projects and ask probing questions to understand the business value of tasks
• Apply expertise in quantitative analysis, data mining, and the presentation of data to see beyond the numbers and understand how customers interact with analytic products
• Partner cross-functionally at all levels of the organization and effectively, both verbally and visually, communicate findings and insights to non-technical business partners
• Independently engage with customers and business partners to gather requirements and validate results
• Communicate and present data-driven insights and recommendations to both internal and external stakeholders, soliciting and incorporating feedback when required
• Provide technical guidance to junior analysts

Must-haves

• Bachelors degree in business, economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance or related field or equivalent experience OR Master's degree.

• 4+ years of experience working with large databases, data verification, and data management or 2+ years of IT experience.

Required Skills

• Experience with Medicare, Medicaid and Marketplace analytics
• Strong SQL skills, including the ability to write and understand complex queries, SELECT statements, and multiple types of JOINs.
• Advanced Excel skills, including: Pivot Tables Power Query VLOOKUP / XLOOKUP Averages, aggregations
• Formatting, Creating and nesting formulas to build metrics and perform financial modeling Power BI experience, with familiarity in DAX and Power Pivot.
• Experience with financial analytics tools and basic financial modeling/sizing Strong understanding of payment methodologies, including DRG pricing, APC, and EAPG payment methodologies

Preferred or Nice-to-have Skills

• Python and R Collaborate with cross-functional teams to evaluate QAI (Quality and Affordability Initiatives), MLR (Medical Loss Ratio) targets, and related key performance indicators (KPIs)

Years of Experience: 4+ years

Industry Experience: Managed Care Analytics - payment methodologies - Medical Economics (Healthcare)

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