What are the responsibilities and job description for the Medical Economics Analyst position at Complete Health?
Medical Economics Analyst will be responsible for working with Medicare Advantage and DCE membership files to produce panel reports, identify new and termed members, and other Medicare Advantage/DCE membership reporting.
ESSENTIAL JOB FUNCTIONS:
- Must be proficient in using SQL Server
- Consolidates monthly patient rosters from payers and disseminates standardized list to various departments (Value Based, Finance, Market Clinical Operations, etc.).
- Develops monthly process to identify new and termed members and work across multiple data systems to consolidate demographic details.
- Communicates with operational teams to meet their data and reporting needs.
- Tracks business requirements from payers regarding cost reallocations and monitors case outcomes.
- Develops monthly processes and procedures for identifying candidates for potential cost reallocations and completes accompanying forms, if applicable, for payer submission.
- Obtain and analyze data to understand how to continually improve processes, procedures and execution.
- Maintain knowledge of current healthcare trends by reading appropriate literature and attending related conferences and/or seminars.
- Relied upon to apply business knowledge to analytics projects and provide value-added insights to directly impact business outcomes.
- 841 Prudential Drive, 17th Floor, Jacksonville, FL 32207
- This is not a remote position
- Salary range $100-115k annually with a 10% bonus
- A relocation package may be available for the right candidate
KNOWEDGE/SKILLS/ABILTIES:
- Proficient in using SQL Server is a must
- Excellent written and verbal communication skills and ability.
- Proficient in Microsoft Office such as Excel, Word, Access, etc.
- Experience with using Power BI strongly preferred.
- Strong analytical, organizational, and problem-solving skills.
- Experience working with complex data sets across claims, lab, financial, clinical outcomes, and external sources.
- Knowledge of medical data structures including, but not limited to (ICD10, CPT, HCPCS, NDC)
- Knowledge of different reimbursement models (DRG, APC, AWP , Cost plus, PDGM)
- Position is based in Jacksonville, FL
- This is not a remote position
- Salary range $100-115k annually with a 10% bonus
- A relocation package may be available for the right candidate
MINIMUM REQUIREMENTS
- Bachelor's degree in Business, Health Care Administration, Mathematics, Finance, Health Informatics, or related field.
- Proficient in SQL Server and Microsoft Suite
- Requires 1- 2 years of experience in healthcare-related data analysis is strongly preferred.
- Masters in relevant field preferred and can be substituted for 2 years' experience.
WORKING ENVIRONMENT
The position requires climbing, stooping, kneeling, crouching, reaching, standing, lifting, grasping, feeling, talking, hearing, repetitive motions, and finger use. Pushing and pulling are occasionally required. Use of a computer, keyboard, and telephone along with various office machines is an essential part of the job.
DISCLAIMER
The above statements are intended to describe the general nature and level of work being performed by the Medical Economics Analyst. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. The Medical Economics Analyst may be required to perform duties outside of their normal responsibilities from time to time as needed or as directed by supervision.
Salary : $100,000 - $115,000
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