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Medical Economics Analyst
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Cleveland, OH Cleveland, Ohio |
About this job
Job Summary:
This position is responsible for providing analytical support and consulting for value based contracts. Responsible for working collaboratively with finance and clinical leadership providing actionable insights on total medical costs, network performance, network leakage, and population health risk economics.
Job Responsibilities:
* Responsible for medical economics analysis, connecting cause and effect of clinical actions on plan performance. Investigates claims and billing data and translate into utilization and cost trends, leakage opportunities, network performance, and population risk profiles would be key.
* Actively collaborates with clinical leadership and institutes to drive clinical action on population health opportunities.
* Other duties as assigned.
Education:
* Bachelor's Degree in Health Informatics, Business or related field required.
* Master degree preferred.
Certifications:
* None required.
Complexity of Work:
* Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.
* Must be able to work in a high pressure situations /deadlines and take appropriate action.
* Must be able to balance analysis vs. over analysis to provide accurate direction insights based on limited data-sets.
* Advanced proficiency in MS Excel required
* Working knowledge of SQL preferred
* Ability to manage conflicting priorities and multiple projects concurrently.
* Strong analytical ability and familiarity with advanced financial and healthcare concepts.
* Ability to effectively communicate and negotiate across various levels.
* Expertise in multiple areas of provider contracting/reimbursement, analysis, modeling & reporting.
* Extensive and diverse knowledge of healthcare data, metrics and coding structures.
* Able to make sound decisions to drive solutions
Work Experience:
* Minimum 3 years of healthcare plan analytics experience with project management experience.
* Experience using diverse data management and analytic tools application (i.e. Access, Business Objects) required.
* Experience using MS Access strongly preferred.
* Experience with OptumOne and Milliman MedInsights preferred.
Physical Requirements:
* Requires extensive sitting and dexterity to perform work on a PC.
* Requires the ability to walk to other parts of the Foundation to attend meetings; must have normal or corrected vision and the
* Ability to verbally communicate to employees and patients.
Personal Protective Equipment:
* Follows standard precautions using personal protective equipment as required for procedures.
#LI-LF1
The policy of Cleveland Clinic and its system hospitals (Cleveland Clinic) is to provide equal opportunity to all of our employees and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. Job offers will be rescinded for candidates for employment who test positive for nicotine. Candidates for employment who are impacted by Cleveland Clinic's Smoking Policy will be permitted to reapply for open positions after 90 days. Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic facility.
Cleveland Clinic is pleased to be an equal employment employer: Women/Minorities/Veterans/Individuals with Disabilities
This position is responsible for providing analytical support and consulting for value based contracts. Responsible for working collaboratively with finance and clinical leadership providing actionable insights on total medical costs, network performance, network leakage, and population health risk economics.
Job Responsibilities:
* Responsible for medical economics analysis, connecting cause and effect of clinical actions on plan performance. Investigates claims and billing data and translate into utilization and cost trends, leakage opportunities, network performance, and population risk profiles would be key.
* Actively collaborates with clinical leadership and institutes to drive clinical action on population health opportunities.
* Other duties as assigned.
Education:
* Bachelor's Degree in Health Informatics, Business or related field required.
* Master degree preferred.
Certifications:
* None required.
Complexity of Work:
* Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.
* Must be able to work in a high pressure situations /deadlines and take appropriate action.
* Must be able to balance analysis vs. over analysis to provide accurate direction insights based on limited data-sets.
* Advanced proficiency in MS Excel required
* Working knowledge of SQL preferred
* Ability to manage conflicting priorities and multiple projects concurrently.
* Strong analytical ability and familiarity with advanced financial and healthcare concepts.
* Ability to effectively communicate and negotiate across various levels.
* Expertise in multiple areas of provider contracting/reimbursement, analysis, modeling & reporting.
* Extensive and diverse knowledge of healthcare data, metrics and coding structures.
* Able to make sound decisions to drive solutions
Work Experience:
* Minimum 3 years of healthcare plan analytics experience with project management experience.
* Experience using diverse data management and analytic tools application (i.e. Access, Business Objects) required.
* Experience using MS Access strongly preferred.
* Experience with OptumOne and Milliman MedInsights preferred.
Physical Requirements:
* Requires extensive sitting and dexterity to perform work on a PC.
* Requires the ability to walk to other parts of the Foundation to attend meetings; must have normal or corrected vision and the
* Ability to verbally communicate to employees and patients.
Personal Protective Equipment:
* Follows standard precautions using personal protective equipment as required for procedures.
#LI-LF1
The policy of Cleveland Clinic and its system hospitals (Cleveland Clinic) is to provide equal opportunity to all of our employees and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. Job offers will be rescinded for candidates for employment who test positive for nicotine. Candidates for employment who are impacted by Cleveland Clinic's Smoking Policy will be permitted to reapply for open positions after 90 days. Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic facility.
Cleveland Clinic is pleased to be an equal employment employer: Women/Minorities/Veterans/Individuals with Disabilities
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