Job Summary:
The Analyst, Medical Economics will support analytical needs across ArchWell Health’s Operations, Clinical, and Finance teams, focused on our markets across Florida, East, and West regions. This will be a colleague motivated by the challenge of assisting internal leaders to understand trends, cost drivers, and financial performance using various data sources. This is a fast-paced position that will enable high-quality personal development and growth.
Duties/Responsibilities:
Analyze claims, membership, and ADT data to identify early signs of trends or other issues related to medical care costs
Perform qualitative analysis to identify cost drivers (utilization and/or rate) to identify and solve business problems and continuously improve data-driven strategies and processes to improve financial results.
Partners with finance and business leaders to create benchmarks to monitor medical cost trends and variances.
Tracks performance of medical cost Key Performance Indicators (KPIs) for markets
Build strong and trusting relationships with market leaders to support and ensure awareness of medical cost issues and challenges.
Structure analytical results in an organized, visual manner to tell a meaningful, actionable story
Execute other duties and special projects as needed, focusing on knowledge and skills development
Required Skills/Abilities:
Proactive initiative in exploring and discovering opportunities to improve company performance through data analysis
Establish trusting, professional relationships with colleagues
Effective organization skills with the ability to work in a very fast-paced, team-oriented environment
Financial and business acumen, problem-solving, and analytical skills with keen attention to detail and accuracy
Knowledge of healthcare/medical economics data such as hospital/physician /ASC claims, utilization data, and healthcare industry coding systems ICD-10, CPT/HCPCS, Revenue Codes, MS/APR-DRGs and APCs
Excellent communication skills across verbal, written, and presentation applications (Microsoft Word, PowerPoint, Excel, etc)
Minimum Qualifications:
Bachelor's degree in STEM (i.e., Applied Math, Statistics, Actuarial Science, Economics, or a related field required)
1-2 years of prior experience as an analyst with a health plan, ACO, RBE, or consulting firm focused on healthcare analytics, decision support, or medical economics
Proficiency in MS Excel, including formulas, PivotTables, PowerBI, graphing and other reporting and presentation features
Experience in data mining, working with healthcare claims and enrollment data in large repositories and/or relational databases with SQL experience strongly preferred
About ArchWell Health:
At ArchWell Health, we’re creating a community of caring designed to help our members stay healthy and engaged. By focusing on a strong provider-patient relationship, routine wellness, and staying active, our members enjoy a higher level of care and better quality of life after the age of 60. Everything we do is for seniors. We believe seniors should be heard, listened to, and given ample time by their physicians to live well later in life. Our value-based care model is designed to prevent illnesses while keeping members healthy and happy in every aspect of their life. We deliver best-in-class primary care at comfortable, accessible neighborhood centers where older adults can feel at home and become part of a vibrant, wellness-focused community. We’re passionate about caring for older adults and united by the belief that caring has the power to change everything for our members.
ArchWell Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected classification.
Originally posted on Himalayas