Senior Medical Economics Analyst

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axialHealthcare is seeking an experienced, healthcare analyst with strong SQL skills who can provide enterprise-wide technical, operational, reporting, and analytical expertise. This is an extremely analytical, individual-contributor role requiring initiative, independence, drive, an ability to work in a dynamic, fast-paced environment, and an ability to perform a wide variety of tasks. As an analytical specialist, this role will provide critical standard and ad-hoc business analysis and reporting of metrics.

Responsibilities

  • Drive analytics and pricing within the value-based healthcare analytics domain through a deep understanding of market trends and customer needs
  • Develop and maintain expert-level of knowledge of risk segmentation, episodes of care, bundled payments, and other industry-specific metrics
  • Lead or participates in complex medical economic projects related to Bundled Payments or Value Based initiatives
  • Remain accountable for all analytic iterative scenario-based modeling and financial projections associated with new strategic initiatives
  • Design and conduct analyses to evaluate the overall effectiveness of Axial’s core programs, including financial and utilization goals, by developing data queries, conducting rigorous analyses using appropriate statistical methods, interpreting results, and presenting findings to leadership
  • Develop and maintain savings models that account for risk adjustment, continuous enrollment, seasonality, trends, etc.
  • Develop intimate knowledge of customer nuances, regional variations, and legislative changes that can be leveraged in analytical value delivery
  • Support efforts to design, implement, and execute alternative payment arrangements and risk/incentive structures with customers
  • Analyze and interpret cost and utilization data, identify key drivers and underlying issues, perform appropriate drill down queries, and summarize, present, and translate findings into meaningful information and actionable results
  • Assist in quality control analysis to ensure client satisfaction and performance guarantees are met and/or exceeded
  • Produce ad hoc, monthly, quarterly and annual reports and analyses
  • Execute prospective client analyses with focus on identifying specific opportunities, and assist related business development activities
  • Monitor the accuracy, completeness, and validity of reporting prior to distribution, and ensure the integrity of data through ongoing analysis
  • Collaborate with the Data Warehouse team on the data architecture necessary to support recurring and ad-hoc claims-based financial impact analyses

Requirements

  • 2+ years of experience working as an analyst in the healthcare industry
  • Analytical experience with claims, providers, eligibility, and related data
  • Expertise in developing complex, legible and well-structured scripts and queries in SQL, SAS or R
  • Experience in data mining and analytic data transformation
  • Experience working with large data repositories and/or relational databases
  • Advanced analytic skills with the ability to analyze and interpret data through complex analysis
  • Ability to work on multiple projects simultaneously with minimal supervision
  • Ability to quickly adapt to changes in both technology and business environments
  • Strong customer service and positive attitude
  • Highly self-motivated and directed with keen attention to detail

Preferred Qualifications

  • Master’s degree in a quantitative field (can be substituted with years of experience or Actuarial exams)
  • Experience with BI Toolsets and multiple SQL dialects preferred.
  • Pricing analysis experience
  • Medical cost savings experience in a health plan
  • General knowledge of health policy, Medicaid, and Medicare