Medical Economics Consultant

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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