Site: Mass General Brigham Health Plan Holding Company, Inc.
Job SummaryMass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are at the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.
Our work centers on creating an exceptional member experience - a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills.
We are pleased to offer competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more.
The Medical Economics Senior Analyst oversees the design, development, and delivery of regulatory reports and financial analyses that support Mass General Brigham Health Plan's external filings and internal interpretation of results. This role requires expertise in financial regulatory reporting. Hands-on experience with Center for Health Information and Analysis (CHIA), Division of Insurance (DOI), and Center for Medicare and Medicaid Services (CMS) submissions is strongly preferred.
The Senior Analyst translates complex regulatory specifications into actionable data logic, ensures accurate and timely report production, and identifies key drivers of cost, utilization, and performance. In addition to independently executing complex analyses, the Senior Analyst helps guide and develop junior staff in the design, programming, validation, and documentation of reporting workflows.
This role partners closely with Actuarial, Finance, Provider Network Management (PNM), Pharmacy, and Product teams to support a broad regulatory portfolio, including CHIA submissions (e.g., Premium, Relative Price, Total Medical Expenses, and Alternative Payment Methods (TME-APM), Primary Care and Behavioral Health (PC-BH), DOI utilization reporting, Pharmacy Rebate, and RxDC filings. The Senior Analyst also serves as the subject matter expert for regulatory reporting, ensuring consistency, audit readiness, and alignment with evolving regulatory requirements.
Essential Functions
-Translate complex regulatory specs into executable data logic, including mapping business definitions to claims, enrollment, pharmacy, and provider data sources.
-Own end-to-end reporting lifecycle: requirements intake, data extraction, transformation, validation, and submission support across recurring annual, quarterly, and monthly filings.
-Execute and enhance reporting workflows for key filings such as CHIA Pharmacy Rebate, RxDC, Premium, Relative Price, Total Medical Expenses and Alternative Payment Methods (TME-APM), Primary Care and Behavioral Health (PC-BH), and DOI utilization reports.
-Develop and maintain reusable code, parameterized logic, and standardized datasets to support repeatable reporting processes.
-Perform rigorous data validation, including reconciliation to prior submissions, financial systems, and BI tools to ensure accuracy and audit readiness.
-Document reporting processes at varying levels of maturity (checklist, step-by-step instructions, and comprehensive guides) to support continuity and scalability.
-Partner cross-functionally with Actuarial, Finance, Product, Pharmacy, and Network teams to source inputs, validate outputs, and resolve data gaps.
-Support internal reporting needs alongside external regulatory deliverables.
QualificationsEducation- Bachelor's Degree required; experience can be considered in lieu of a degree
Experience- At least 5-7 years of experience in data analysis required
- Experience running CHIA Pharmacy Rebate, RxDC, Premium, Relative Price, Total Medical Expenses and Alternative Payment Methods (TME-APM), Primary Care and Behavioral Health (PC-BH), and DOI utilization reports is highly preferred
Knowledge, Skills, and Abilities- Strong knowledge of relational databases, SQL, data visualization, and Business Intelligence tools, such as Tableau.
- Strong proficiency with Microsoft Office Suite, including Word, Excel, and PowerPoint.
- Ability to communicate complex workflows and data to a variety of audiences.
- Project management skills and/or experience are a plus.
- Knowledge and application of statistical analyses, including variance analysis and statistical significance preferred.
- Healthcare knowledge, particularly as it pertains to electronic medical record data, is preferred but not required.
Additional Job Details (if applicable)Working Conditions - This is a remote role that can be done from most US states
- Schedule is Monday through Friday, 8:30 AM - 5:00 PM Eastern
- Employees must use a stable, secure, and compliant workstation in a quiet environment. Teams video is required and must be accessed using MGB-provided equipment.
Remote TypeRemote
Work Location399 Revolution Drive
Scheduled Weekly Hours40
Employee TypeRegular
Work ShiftDay (United States of America)
Pay Range$79,560.00 - $115,720.80/Annual
Grade7
At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.
