What are the responsibilities and job description for the Manager, Medical Economics position at Astrana Health?
Job Details
Job Description
Job Description
Description
What You'll Do
Qualifications
Environmental Job Requirements and Working Conditions
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided based on qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.
We are looking for a full-time Manager, Medical Economics to join our fast-growing team. This is a team with exceptionally high visibility; you will be a core member of a team that uses data and analysis to steer Astrana Health s growth via provider & payer contract negotiations. We have a startup-like mentality & career trajectory in a recently IPO d, rapidly growing company. This role would report to our Director, Medical Economics.
Our Values:
Our Values:
- Put Patients First
- Empower Entrepreneurial Provider and Care Teams
- Operate with Integrity & Excellence
- Be Innovative
- Work As One Team
What You'll Do
- Mine data to discover key analytical insights for decision support, with a focus on evaluating & improving financial and operational performance on our health plan and institutional contracts
- Build deal models for institutional, health plan, and provider contract negotiations, including Medicare Advantage, Commercial Risk, Medi-Cal, and Fee-for-Service
- Identify cost-of-care savings opportunities by analyzing physician authorizing/billing patterns in relation to hospital admissions, emergency room visits, office visits, referral practices, and specialty care procedures and provide suggestions for vendor contract changes that can result in cost savings
- Use data tools (e.g. SQL, Excel) for tracking, analyzing, forecasting and reporting on payors & hospitals financial impact
- Identify, develop, and document audit findings to present to key stakeholders
- Help develop proprietary analytics infrastructure, including various reports and dashboards, supporting our institutional and payor financial performance
- Maintain and improve existing reporting infrastructure to support a variety of internal stakeholders from other teams
- Mentor and manage a robust team of analysts
- Complete a variety of strategic adhoc projects as assigned
Qualifications
- Bachelor's degree in quantitative field such as finance, statistics, economics, math or engineering is preferred; Master s degree (MBA, MHA, MPH) is preferred
- Minimum 6 years of experience full-time in managed care or healthcare data analytics field; Health Plan or Provider Group experience preferred
- Prior experience in an analytical/reporting role developing financial and operational models
- Working knowledge of healthcare pricing and reimbursement methodologies for Medicare, Medicaid/Medi-Cal (CPT/HCPCS, DRG, etc.)
- Basic understanding of healthcare policy trends (e.g. value based care)
- Prior experience in project management and/or process improvement (current state analysis) (Preferred)
- Proficiency in Excel (e.g. pivot tables, data manipulation), PowerPoint, and Word required
- Proficiency with SQL or similar relational databases is required
- Ability to process and analyze data to tell an accurate story via data visualizations, dashboards, and reports
- Strong problem-solving, troubleshooting, and analytical skills with demonstrated ability to develop new reporting and insights using complex data environments
- Strong oral and written communication; ability to communicate effectively across various levels & functions within the organization
Environmental Job Requirements and Working Conditions
- This is a remote role within the United States.
- The target pay range for this role is: $120,000 - $140,000. This salary range represents our national target range for this role.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided based on qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.
Salary : $120,000 - $140,000
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