Medical Economics Consultant

Highmark

$79K — $127K *
US-Anywhere
+ 49 other locationsRemote
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in Business, Health, Economics, Mathematics/Actuarial Sciences or a related area
  • 5 years of experience in Medical Economics, Healthcare Analytics, or Actuarial Services in the healthcare payer sector
  • Proven analytical ability to meet business timelines and outcomes
  • Strong technical data skills (SAS, SQL, R, Tableau, Excel)
  • Experience collaborating with business partners for analytics and communication

Responsibilities

  • Provide strategic insights into emerging medical cost trends and develop executive presentations
  • Analyze large datasets using SAS, SQL or similar tools
  • Assess strategic medical cost programs for business areas and coordinate savings projections
  • Drive independent medical cost analytics and present insights into claim cost drivers
  • Create the executive leadership financial report with insights on program impact
  • Collaborate with other departments in a matrixed work environment
  • Other duties as assigned

Benefits

  • Hybrid or remote work options for those within 50 miles of an office
  • Opportunity for professional development and training
  • Engagement in a dynamic healthcare environment
  • Access to advanced analytical tools and resources
Full Job Description
JOB SUMMARY

This job is responsible for the financial reporting of Highmark's strategic cost of care savings program. The ideal candidate will be comfortable gathering financial data from multiple business partners, performing quality checks on the data, performing financial analysis on the data and creating the executive leadership financial report. The incumbent will have proven detailed technical and analytical experience with strong communication and influencing skills. More specifically, the candidate will take ownership of delivering a high-quality financial report with key insights on the emerging program impact to the health plan. Someone with an eye for detail and a drive to continuously improve processes is preferred. Using data driven analytics, the ideal candidate will: 1) develop dashboards and reports showing total program impact to the health plan, 2) track the outcomes of the programs, and 3) provide strategic insight into areas of focus/opportunities.

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


EXPERIENCE

Required
  • 5 years of Medical Economics, Healthcare Analytics, Informatics and/or Actuarial Services in the health care payer sector


Preferred
  • Strong coding background (R, R Shiny, Python, SQL, etc.). Experience building dashboards in Tableau, Power BI, or R Shiny.


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

Hybrid or Remote - if you live within 50 miles of an office you are required to be onsite 3 days a week. T, W, Th.

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

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Rarely

Lifting: 25 to 50 pounds

Never

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

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