Senior Medical Economics Analyst (Remote) - Health Alliance Plan

📁
Clinical/Allied Health
📅
2413898 Requisition #

GENERAL SUMMARY:

As a Senior Medical Economics Analyst, your primary objective will be to identify, analyze, and explain emerging medical trends. You will play a crucial role in identifying opportunities for cost containment and quality improvements initiatives.

 PRINCIPLE DUTIES AND RESPONSIBILITIES:

  • Conduct analysis associated with medical cost containment initiatives. Analyze medical and pharmacy claims to identify early signs of trends or other issues related to medical care costs.
  • Perform qualitative analysis to pinpoint cost drivers (such as utilization, pricing, and service mix), address business challenges, and continuously enhance data-driven strategies and processes to improve financial results.
  • Evaluate vendor and partnership performance, focusing on value and return on investment (ROI), and communicate findings to key leadership and stakeholders.
  • Collaborate with finance and business leaders to establish benchmarks for monitoring medical cost trends and variances.
  • Demonstrate proficiency in healthcare/medical economics data and an understanding of healthcare industry coding systems such as ICD-10, CPT/HCPCS, and DRGs.
  • Take proactive initiative and show curiosity in exploring new opportunities to enhance cost-saving strategies and improve overall financial performance.
  • Participate in and/or lead cross-functional corporate business teams and meetings to develop medical economics programs.
  • Communicate and present findings to key leadership and stakeholders, addressing business questions and objectives.
  • Prepare reports and presentations for quarterly business meetings.
  • Perform other related duties as assigned.

EDUCATION/EXPERIENCE REQUIRED:

  • Must have an undergraduate (BS) degree in Statistics, Mathematics, Economics, Public Health, and Finance or another related field.
  • Master’s degree preferred.
  • Minimum of three (3) years of progressive analytical experience in a healthcare or managed care/insurance related setting.
  • Minimum of one (1) year of experience in leading staff in projects or supervisory/management position preferred.
  • Skills required: SQL, Excel.
  • Skills preferred: Microsoft PowerBI, SAS, R.
  • Demonstrated experience with data interpretation, analysis, and reporting; clinical and financial data; risk modeling and forecasting; key performance indicators as it relates to medical cost data.
  • Demonstrated project management experience in running corporate wide projects.
  • Experience in mining and migrating medical cost performance data to a single platform preferred.

The nature of the work requires progressive interpersonal communication, decision- making, financial and technical skills. Ability to ideate, improve processes, calculate measures, and leverage BI solutions to improve healthcare performance.

  • Must exhibit the ability to function in an autonomous manner in a rapidly changing environment.
  • High energy: strong leadership, analytical, project planning and coordination skills to enable efficient, timely task completion of deliverables that meet or exceed customer expectations.
  • Demonstrated ability to function in a creative, "out-of-the-box" way of thinking to develop original solutions to overcome roadblocks and meet or exceed customer requirements and expectations.
  • Knowledge of medical claims data and managed care membership data.
  • Knowledge of business intelligence applications, data, and tools.
  • Advanced Microsoft analytic skills (e.g., Access, Excel, and PowerBI).
  • Knowledge of Medicare and Commercial Reimbursement methodologies a plus.

Overview

HAP is a Michigan-based, nonprofit health plan that provides health coverage to individuals,          companies and organizations. A subsidiary of Henry Ford Health System, we partner with doctors, employers and community groups to enhance the overall health and well-being of the lives we touch. With more than 1,100 dedicated and passionate employees, our goal is to make health care easy for our members.

 

Under the leadership of President and CEO Robert G. Riney, Henry Ford Health is a

$6 billion integrated health system comprised of six hospitals, a health plan, and 250+ sites

including medical centers, walk-in and urgent care clinics, pharmacy, eye care facilities and

other healthcare retail. Established in 1915 by auto industry pioneer Henry Ford, the health system

now has 32,000 employees and remains home to the 1,900-member Henry Ford Medical Group, one

of the nation’s oldest physician groups. An additional 2,200 physicians are also affiliated with the

health system through the Henry Ford Physician Network. Henry Ford is also one of the region’s  

major academic medical centers, receiving between $90-$100 million in annual research funding and

remaining Michigan’s fourth largest NIH-funded institution. Also an active participant in medical

education and training, the health system has trained nearly 40% of physicians currently practicing

in the state and also provides education and training for other health professionals including nurses,

pharmacists, radiology and respiratory technicians. visit HenryFord.com.

Benefits

Whether it's offering a new medical option, helping you make healthier lifestyle choices or

making the employee enrollment selection experience easier, it's all about choice.  Henry

Ford Health System has a new approach for its employee benefits program - My Choice

Rewards.  My Choice Rewards is a program as diverse as the people it serves.  There are

dozens of options for all of our employees including compensation, benefits, work/life balance

and learning - options that enhance your career and add value to your personal life.  As an

employee you are provided access to Retirement Programs, an Employee Assistance Program

(Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness

and access to day care services at Bright Horizons Midtown Detroit, and a whole host of other

benefits and services. Employee's classified as contingent status are not eligible for benefits

Equal Employment Opportunity/Affirmative Action Employer

Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health System is

committed to the hiring, advancement and fair treatment of all individuals without regard to

race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,

weight, marital status, family status, gender identity, sexual orientation, and genetic information,

or any other protected status in accordance with applicable federal and state laws.

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