Position Overview:

The primary goal of the Senior Medical Economics Analyst is to provide analytical support for value-based payment programs, including monitoring/measuring the performance of the initiatives by leveraging claims, financial, clinical, and benchmark data from multiple internal and external sources. This individual will be responsible for evaluating key population health metrics and presenting findings to executives, physicians, and external stakeholders in order to support the design, development, and implementation of programs that improve performance of health outcomes across multiple populations. With these goals in mind, the individual will support end-to-end solution development including but not limited to: analytics/BI products tailored to providers/health system stakeholders, population health improvement initiatives, ad-hoc reporting requests, and monthly performance reporting. Additionally, the Senior Medical Economics Analyst will partner with the actuarial team to develop new provider payment and network models to support more coordinated, efficient and quality-driven healthcare. This role requires collaboration with national stakeholders and other analysts on cross-functional project teams.

Essential Duties and Responsibilities (including but not limited to the following):

• Participating in the development of analytical tools and data reports that will monitor organizational progress against health outcomes measures and medical cost trends.
• Updating and creating reports that track value based incentive program performance for different provider types including but not limited to hospitals, ACOs, home health, and skilled nursing facilities.
• Providing required analysis in order to understand savings, medical cost and utilization drivers, as well as providing insightful commentary and sensitivity modeling analyses.
• Developing alternative payment models and other innovative risk sharing arrangements.
• Manipulating and transforming complex data sets from multiple internal and external sources.
• Performing hands-on tasks, including with data acquisition from disparate systems, data transformation and analysis and communicating findings.
• Applying advanced analytical methods to improve decision-making and strategic direction.

Qualifications:

• Previous experience working with large databases, e.g. health insurance claims databases, data warehousing, and/or database administration required.

• Applied experience with EMR data & clinical analytic processes, strongly preferred.
• Proficiency in SQL (SSMS, preferred) and SAS required.
• Decided advantage to any candidates with experience with the following: SSRS/SSIS packages, Python, R, Azure, Alteryx, or Visualization (Tableau/Power BI).
• Must have strong analytical and problem-solving skills.
• Familiarity with claims / encounter data, as well as Medicare / commercial reimbursement methodologies required.
• Experience leading other analysts in developing capabilities.
• Strong communication skills, including an ability to communicate with staff at various levels, including both front line staff and senior management.

• Prior experience with healthcare analytics, informatics, and population health concepts.
• Strong understanding of Medicare Advantage plans and value-based incentive programs a decided advantage.

Experience: 5-12+ years of analytical or actuarial work experience within the healthcare industry (i.e. consulting, hospitals, managed care organization, etc.)

Education: Bachelor’s degree in quantitative disciplines (mathematics, statistics, economics, etc.), or related field.

Colorado, Connecticut, Nevada or NYC Residents Only: The pay range for Colorado residents is $97,300 to $176,900 per year. The pay range for Connecticut / Nevada/NYC residents is $97,300 to $176,900. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your base compensation, Optum Medical Care, P.C. offers benefits such as, a comprehensive benefits package, incentive and recognition programs, and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with Optum Medical Care, P.C. you’ll find a far-reaching choice of benefits and incentives.

All qualified applicants will receive consideration for employment without regard to race, ethnicity, color, religion, sex, gender identity, sexual orientation, national origin, disability, or protected veteran status. CareMount is an EO employer – M/F/Veteran/Disability