Analyst, Health Economics

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We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us.

Job Summary

The Health Economics Analyst will conduct financial and operational analysis in order to meet or exceed quality metrics, financial targets, and other value-based benchmarks. This role maintains and analyzes a variety of internal and external data sets to facilitate meaningful insights that are used to improve the effectiveness and timeliness of business decisions. The analyst will play a critical role in managing and optimizing our stop loss insurance policies to minimize financial risk and support the overall financial health of the organization. The ideal candidate should have a strong analytical mindset, excellent problem-solving skills, and a deep understanding of healthcare and insurance terminology.

Duties & Responsibilities

Essential Duties & Responsibilities

• Data Analysis and Interpretation:
  • a. Analyze healthcare data, including cost, utilization, and outcome metrics, to identify patterns and trends.
  • b. Interpret economic and financial data related to healthcare systems, services, and policies.

• Economic Modeling:
  • a. Develop economic models to assess the impact of healthcare interventions, policies, and programs.
  • b. Utilize statistical methods and modeling techniques to simulate economic scenarios and evaluate potential outcomes.

• Stop Loss Policy Management:
  • a. Analyze and manage the organization's stop loss policies to ensure they are structured and priced effectively.
  • b. Monitor policy performance and assess the impact on the company's financials.

• Claims Analysis:
  • a. Review and analyze claims data to identify trends, outliers, and potential cost-saving opportunities.
  • b. Collaborate with the Business Intelligence team to ensure accurate reporting and documentation.

• Risk Assessment:
  • a. Assess the organization's risk exposure related to stop loss insurance.
  • b. Develop strategies to mitigate risks and reduce financial losses.

• Data Analysis:
  • a. Utilize data analysis tools and software to extract valuable insights from large datasets.
  • b. Generate reports and presentations to communicate findings to the management team.

• Policy Renewals and Negotiation:
  • a. Coordinate the renewal process for stop loss policies.
  • b. Collaborate with insurance providers and brokers to negotiate terms and pricing.

• Compliance and Regulatory Knowledge:
  • a. Stay updated on industry regulations and compliance requirements related to stop loss insurance.
  • b. Responsible for executing and monitoring ongoing control procedures and documentation related to compliance with Sarbanes-Oxley requirements and for the remediation of control deficiencies, if any.

Supervisory Responsibilities

• No supervisory responsibilities.

Education & Experience

• Bachelor’s degree in Finance, Data Analytics, Economics, Business, or a related field. A master's degree or relevant professional certification is a plus.

Knowledge, Skills & Proficiencies

• Strong analytical skills and the ability to work with complex data.

• Proficiency in data analysis and modeling tools (e.g., Excel, SQL, and PowerBI).

• Experience in stop loss insurance, risk management, or related fields is a plus.

• Knowledge of healthcare and insurance industry terminology.

• Excellent communication skills and the ability to present findings to both technical and non-technical stakeholders.

• Detail-oriented and organized, with the ability to manage multiple tasks simultaneously.

• Strong problem-solving and critical thinking abilities.

Physical Requirements

The employee is required to work at a personal computer as well as be on the phone for extended periods of time. Must be able to stand, sit, walk, and occasionally climb. The incumbent must be able to work extended and flexible hours and weekends as needed.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Work Conditions

Must be able to perform essential functions such as typing, standing, sitting, stooping, and occasionally climbing

Travel Requirements

Travel Required

Amount of Expected Travel

Details

No

Tools & Equipment Used

Computer and peripherals, standard and customized software applications and tools, and usual office equipment.

Disclaimer

The duties and responsibilities described above are designed to indicate the general nature and level of work performed by associates within this classification. It is not designed to contain, or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of associates assigned to this job. This is not an all-inclusive job description; therefore, management has the right to assign or reassign schedules, duties, and responsibilities to this job at any time. Cano Health is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.

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