Blue Cross Blue Shield of Rhode Island

Senior Medical Economics Analyst

US-AnywhereRemote in Providence, RI
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's or Master's degree in a quantitative field (Mathematics, Statistics, Economics, Data Science, or Health Informatics)
  • Minimum 5+ years in healthcare data analysis within a health plan or payer setting
  • Deep understanding of healthcare claims, member enrollment, and standard metrics (PMPM, utilization rates, risk adjustment)
  • Proven ability to manage multiple projects autonomously in a fast-paced environment
  • Advanced SQL skills for data extraction and manipulation
  • Proficiency in Python for data analysis and automation
  • Experience with building dashboards using Power BI or Snowflake capabilities
  • Experience in a Snowflake environment is a plus

Responsibilities

  • Analyze medical claims and healthcare data to identify trends and cost-saving opportunities
  • Partner with leaders to scope new initiatives and assess their financial impact
  • Present insights and analytics directly to business leaders for strategic decision-making
  • Explore and adopt new tools for enhancing insight generation and predictive capabilities
  • Monitor outcomes of cost-saving initiatives post-implementation

Benefits

  • Support for associate well-being and work-life balance
  • Flexible work schedules including in-office, hybrid, and remote options
  • Convenient headquarters location near public transportation
  • Opportunity to make a significant impact in healthcare affordability
Full Job Description
Pay Range:
$93,600.00 - $140,400.00
Please email if you are a candidate seeking a reasonable accommodation for the application and/or interview process.

Why this job matters:

We are a growing regional health plan dedicated to making healthcare more accessible and affordable for the communities we serve. As a lean, high-impact team, we rely on data-driven insights to manage costs, evaluate clinical programs, and shape the Total Cost of Care (TCOC) and the organizational strategy.

We are seeking a motivated Senior Medical Economics Analyst to play a pivotal role in solving the healthcare affordability crisis. Operating with limited oversight, you will dive deep into medical claims and healthcare data to uncover cost drivers and translate complex data into actionable strategies. As a key partner to business leaders, you will play an important role in the design, value, and monitoring of cost-saving initiatives from conception through post-implementation value realization.

If you are a self-starter with a passion for analytics, strong technical skills, and the drive to make a tangible difference in healthcare affordability, we want you on our team.

What you will do:
  • Cost Driver Analysis: Analyze medical claims and related healthcare data to identify trends, cost drivers, and opportunities for medical cost savings.
  • Initiative Valuation & Monitoring: Partner with cross-functional leaders to scope new initiatives, calculate the potential financial impact, and monitor outcomes post-implementation for value realization.
  • Leadership Reporting: Synthesize complex analytics into clear, actionable insights and present findings directly to business leaders to drive strategic decisions.
  • Tool Innovation: Continuously explore and adopt new tools and technologies to elevate our insight generation and predictive capabilities.


What you need to succeed:
  • Education: Bachelor's or Master's degree in a quantitative field (e.g., Mathematics, Statistics, Economics, Data Science, or Health Informatics).
  • Experience: Minimum 5+ years of experience analyzing healthcare data-preferably within a health plan or payer setting-and presenting actionable insights to leadership.
  • Industry Knowledge: Deep understanding of healthcare claims, member enrollment, provider data, and standard healthcare metrics (e.g., PMPM, utilization rates, risk adjustment).
  • Autonomy: Proven ability to operate as a self-starter with limited oversight, managing multiple projects in a fast-paced environment.
  • SQL: Advanced SQL expertise for complex data extraction, manipulation, and ETL processes.
  • Programming: Proficiency in Python for data analysis, modeling, and automation.
  • Visualization: Strong experience building interactive dashboards and visualizations using Power BI or Snowflake's native capabilities.
  • Data Platforms: Experience working within a Snowflake environment is highly preferred; familiarity with modern data stack tools is a plus.


Location:
BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role:
  • In-office: onsite 5 days per week
  • Hybrid: onsite 2-4 days per week
  • Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia

About Blue Cross Blue Shield of Rhode Island

Blue Cross Blue Shield of Rhode Island is a non-profit health insurance company that provides medical, dental, and vision coverage to individuals and businesses in Rhode Island. The company also offers Medicare Advantage plans and prescription drug coverage. Blue Cross Blue Shield of Rhode Island was founded in 1939 and is headquartered in Providence, Rhode Island.
Learn more about Blue Cross Blue Shield of Rhode Island
Size
800 employees
Industry
Founded
1939

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