Senior Healthcare Economics Analyst

Summary: * Work with other team leaders to improve operational efficiencies and resource allocations for improved performance of the EmblemHealth plans. * Responsible for running queries and providing required analysis to understand related drivers (such as medical cost and utilization), and to provide insightful commentary and sensitivity modeling analysis. * Develop data-driven analysis for decision making on how EmblemHealth purchases, manages, and influences the cost of care for current and prospective members. * Extract, analyze, and interpret data for more complex insights related to cost drivers and to manage the escalation of issues that impact costs, and impact of health cost containment initiatives. * Provide consultative subject matter expertise to aligned business areas to demonstrate analytics rooted in data. Responsibilities: * Ensure data integrity is maintained throughout the reporting lifecycle. * Implement reporting and reconciliation workflows and document processes. * Responsible for experience studies and medical trend studies. * Perform research and collection of data, including data mining and reporting, which is provided to various customers inside and outside the department. * Implement automation of manual reporting and analysis of business implications and trends. * Lead efforts to continually improve data capabilities and quality of department analysis and reporting. * Create, develop, and design analytics and reporting to measure or estimate financial impact of health plan business problems and potential or actual solutions, addressing escalated issues with subject matter expertise. * Lead and manage several corporate and health cost containment initiatives, supporting staffing to deliver results across all functions within Medical Economics. * Develop research and analytic processes to review financial data to draw conclusions for senior leadership. * Represent the department to internal and external partners with presentation of data and results for use in administering specific programs and processes related to medical expense and utilization. * Present analytical findings to internal business partners, leading discussions and providing delivery of further analysis. * Analyze business problems related to financial experience of the health plan, particularly related to how care is purchased, managed, or other factors influencing cost of care. * Perform additional duties as assigned. Requirements: * BA/BS in Mathematics, Statistics, Economics, Healthcare or related discipline required; Master's preferred. * 4 - 6+ years' experience working in a healthcare setting (within a provider health system or health insurance company) required * Ability to query, summarize, and manipulate data using SQL or SAS required * High level of proficiency with MS Office (Word, Excel, PowerPoint, Outlook, etc.), with an emphasis on Excel required * Experience working in a healthcare setting (within a provider health system or health insurance company) preferred * Experience working with healthcare data including but not limited to claims, testing results and pharmacy data required * Strong communication skills (verbal, written, presentation, interpersonal) required * Experience preparing/presenting dashboards and data using a data visualization tool such as Tableau preferred Additional Information * Requisition ID: 1000002483 * Hiring Range: $68,040-$118,800

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