Description
JOB SUMMARY
The Medical Economics Consultant is responsible for the development, coordination and management of medical economics analysis, models, health outcome studies and related forecasting and actual results analysis related to the portfolio of activities that are focused on operating margin improvements, primarily focused on medical spend.
This work will leverage market-leading health plan medical economics processes, tools and reporting. This key new role will serve as the key link between the Finance / Consultative work in support of these initiatives and each business segment and functional area partners' work, with focus on 1) the analysis development to size the ideation, emerging results and financial impact 2) infrastructure and process development to link medical economic related analytics (trend reporting, medical cost, conditions, etc.
with business partner actions, including progress and impact. 3) dashboard building of financial information that will help track / evaluate initiative level activities.
ESSENTIAL RESPONSIBILITIES
- Provide strategic / tactical insights into emerging medical cost trends. Develop executive ready presentations explaining analytical findings in a clear concise manner.
- Proficiency to extract, summarize and analyze large datasets via SAS, SQL or other similar tools.
- Provide business areas with opportunity assessments of their strategic medical cost programs. Coordinate savings opportunity projections and post implementation savings measurements.
Develop improved business case and savings estimate capabilities to enable more accurate and deeper projections.
- Leverage analytical experience and knowledge to drive independent medical cost analytics; develop areas of opportunity using a fact-based analysis, present medical cost analytics and insight into claim cost drivers to key business partners.
- Strong communication skills (verbal and executive quality presentations) to present clear, concise presentations of the detailed analytics.
- Work in a matrixed work environment. Partner with other departments in developing the full analytical story.
- Other duties as assigned or requested.
EDUCATION
Required
Bachelor's Degree in Business, Health, Economics, Mathematics / Actuarial Sciences or other related area
Substitutions
None
Preferred
- Master's Degree in Business, Health, Economics, Mathematics / Actuarial Sciences or other related area
- Master's degree in STEM majors
EXPERIENCE
Required
5 years of Medical Economics, Healthcare Analytics, Informatics and / or Actuarial Services in the health care payer sector
Preferred
- Strong Technical Data Skills (SAS / SQL / R, Tableau, Excel, PowerBI, etc.)
- Comfort with ambiguity yet unstoppable drive to create order out of chaos
- Passion for evolving quantitative methods; flexible in approaches such that you see opportunities for data where others might see constraints
LICENSES AND CERTIFICATIONS
Required
None
Preferred
None
SKILLS
- Proven analytical ability to drive independent work and meet business timelines and outcomes.
- Strong Technical Data Skills (SAS / SQL, R, Tableau, Excel, etc.)
- Demonstrated ability to work with business partners in communicating outcomes, partnering on analytics, and developing new approaches to breaking down a strategic hypothesis.
- Experience in the healthcare Industry, with solid knowledge of emerging trends and challenges
Languages (Other then English)
None
Travel Required
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office-Based
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products / services (sales employees)
Never
Physical work site required
Lifting : up to 10 pounds
Constantly
Lifting : 10 to 25 pounds
Rarely
Lifting : 25 to 50 pounds
Never
Pay Range Minimum : $67,500.00
$67,500.00
Pay Range Maximum : $124,800.00
$124,800.00
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation / gender identity or any other category protected by applicable federal, state or local law.
Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation / gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities / Women / Protected Veterans / Disabled / Sexual Orientation / Gender Identity ()
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