BA/BS in Mathematics, Statistics, Economics, Healthcare, or related field; Master's preferred.
5-8+ years of relevant professional experience.
Experience in a healthcare setting (provider health system or health insurance company) preferred.
Proficient in healthcare data analysis, including claims and pharmacy data.
High proficiency in MS Office, especially Excel.
Strong communication skills across various formats.
Experience with data visualization tools like Tableau preferred.
Ability to manipulate data using SQL or Python.
Responsibilities
Guide a team of financial analysts in delivering actionable data and analysis.
Initiate and develop analytics for strategic decision-making and provide recommendations to senior management.
Design and lead data-driven analysis for cost management of care for members.
Analyze data to identify cost drivers and opportunities for cost impact.
Provide consultative support to business areas, demonstrating data-rooted analytics.
Lead execution of analytics to measure financial impacts of health plan issues and solutions.
Present analytical findings to internal and external partners.
Benefits
Remote work flexibility.
Opportunities for professional development and mentorship.
Engagement in strategic decision-making processes.
Access to advanced data analytics tools and resources.
Collaboration with cross-functional teams.
Full Job Description
REMOTE
Summary of Position
Provide guidance to a team of financial analysts who provide timely, accurate, actionable data and analysis supporting the department, other business areas, and corporate key initiatives.
Proactively initiate and develop analytics for strategic and operating decisions and provide recommendations to senior management.
Design and lead development of data-driven analysis for decision making on how EmblemHealth purchases, manages, and influences the cost of care for current and prospective members.
Analyze, and interpret data to produce insights related to cost drivers, opportunities to impact costs, and impact of health cost containment initiatives.
Provide consultative support to aligned business areas to demonstrate analytics rooted in data.
Principal Accountabilities
Design and lead execution of analytics and reporting to measure or estimate financial impact of health plan business problems and potential or actual solutions.
Provide leadership across all functions within Healthcare Economics including monitoring of specific corporate and health cost containment initiatives.
May lead/mentor less experienced staff.
Research and analyze financial data to draw conclusions and provide consultation to internal and external partners for use in administering specific programs and processes related to medical expense and utilization.
Provide guidance and subject matter expertise to perform complex analyses; serve as point of escalation to resolve the most complex issues.
Present analytical findings to internal and external business partners.
Plan, conduct and direct work on complex projects/programs related to financial experience of the health plan, particularly related to how care is purchased, managed, or other factors influencing cost of care.
Advise management in long-range planning for areas of specialization.
Perform additional duties as assigned.
Qualifications
Education, Training, Licenses, Certifications
BA/BS Required in Mathematics, Statistics, Economics, Healthcare or other related discipline required; Master's preferred.
Relevant Work Experience, Knowledge, Skills, and Abilities
5 - 8+ years of relevant, professional work experience. (Required)
Experience working in a healthcare setting (within a provider health system or health insurance company). (Preferred)
Experience working with healthcare data including but not limited to claims, testing results and pharmacy data. (Required)
High level of proficiency with MS Office (Word, Excel, PowerPoint, Outlook, etc.), with an emphasis on Excel. (Required)
Strong communication skills (verbal, written, presentation, interpersonal). (Required)
Experience preparing/presenting dashboards and data using a data visualization tool such as Tableau. (Preferred)
Ability to query, summarize, and manipulate data using SQL or Python. (Required)
About EmblemHealth
EmblemHealth is a non-profit health insurance company based in New York City. It is one of the largest non-profit health insurers in the United States, serving over 3 million people. EmblemHealth offers a range of health insurance plans, including HMO, PPO, and EPO plans, as well as Medicare and Medicaid plans. The company also offers wellness programs and disease management services. EmblemHealth was formed in 2006 through the merger of Group Health Incorporated (GHI) and the Health Insurance Plan of Greater New York (HIP). The company has offices in New York City and Albany, New York.
