EmblemHealth

Senior Healthcare Economics Analyst

EmblemHealth • $90K — $120K *
New York, NY 10025In-Person
Healthcare
Less than 5 years of experience
Today
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Job Overview by Ladders

Qualifications

  • BA/BS in Mathematics, Statistics, Economics, Healthcare or related discipline; Master's preferred.
  • 4 - 6+ years' experience in a healthcare setting (provider health system or health insurance company).
  • Proficient in querying and manipulating data using SQL or SAS.
  • Expertise in MS Office Suite, especially Excel.
  • Familiarity with healthcare data like claims and pharmacy data.
  • Excellent communication skills (verbal, written, presentation).
  • Experience with data visualization tools like Tableau preferred.

Responsibilities

  • Ensure data integrity throughout reporting lifecycle.
  • Implement workflows for reporting and reconciliation, documenting processes.
  • Conduct experience and medical trend studies.
  • Gather and analyze data for reporting to internal and external customers.
  • Automate manual reporting and analyze business implications and trends.
  • Lead enhancement of data capabilities and reporting quality.
  • Design analytics and reporting measuring financial impact of health plan issues.
  • Manage corporate initiatives in health cost containment and staffing delivery results.
  • Develop processes to review financial data for senior leadership insights.
  • Present data findings to partners, aiding in program administration.
  • Facilitate discussions based on analytical findings with internal staff.
  • Analyze financial experience related to healthcare purchasing and cost factors.

Benefits

  • Comprehensive healthcare package.
  • Opportunities for professional development.
  • Flexible work options.
  • Collaborative and supportive team environment.
  • Access to cutting-edge tools and technologies.
Full Job Description
Summary:
  • Work with other team leaders to improve operational efficiencies and resource allocations for improved performance of the EmblemHealth plans.
  • Responsible for running queries and providing required analysis to understand related drivers (such as medical cost and utilization), and to provide insightful commentary and sensitivity modeling analysis.
  • Develop data-driven analysis for decision making on how EmblemHealth purchases, manages, and influences the cost of care for current and prospective members.
  • Extract, analyze, and interpret data for more complex insights related to cost drivers and to manage the escalation of issues that impact costs, and impact of health cost containment initiatives.
  • Provide consultative subject matter expertise to aligned business areas to demonstrate analytics rooted in data.


Responsibilities:
  • Ensure data integrity is maintained throughout the reporting lifecycle.
  • Implement reporting and reconciliation workflows and document processes.
  • Responsible for experience studies and medical trend studies.
  • Perform research and collection of data, including data mining and reporting, which is provided to various customers inside and outside the department.
  • Implement automation of manual reporting and analysis of business implications and trends.
  • Lead efforts to continually improve data capabilities and quality of department analysis and reporting.
  • Create, develop, and design analytics and reporting to measure or estimate financial impact of health plan business problems and potential or actual solutions, addressing escalated issues with subject matter expertise.
  • Lead and manage several corporate and health cost containment initiatives, supporting staffing to deliver results across all functions within Medical Economics.
  • Develop research and analytic processes to review financial data to draw conclusions for senior leadership.
  • Represent the department to internal and external partners with presentation of data and results for use in administering specific programs and processes related to medical expense and utilization.
  • Present analytical findings to internal business partners, leading discussions and providing delivery of further analysis.
  • Analyze business problems related to financial experience of the health plan, particularly related to how care is purchased, managed, or other factors influencing cost of care.
  • Perform additional duties as assigned.


Requirements:
  • BA/BS in Mathematics, Statistics, Economics, Healthcare or related discipline required; Master's preferred.
  • 4 - 6+ years' experience working in a healthcare setting (within a provider health system or health insurance company) required
  • Ability to query, summarize, and manipulate data using SQL or SAS required
  • High level of proficiency with MS Office (Word, Excel, PowerPoint, Outlook, etc.), with an emphasis on Excel 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
  • Strong communication skills (verbal, written, presentation, interpersonal) required
  • Experience preparing/presenting dashboards and data using a data visualization tool such as Tableau preferred

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.
Learn more about EmblemHealth
Size
3,000 employees
Industry
Healthcare
Net Income
-$100 million
Founded
2006
5 Year Trend
-5%
Revenue
$10 billion
NASDAQ
* Ladders Estimates

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