[Hiring] Medical Economics Consultant @Amerihealth Caritas

Role Description

The Medical Economics Consultant position reports to the Manager of Medical Economics and Business Processes. This position is primarily responsible for supporting the development of market trend analytics, enterprise-wide trends, executive decks, & enhanced metrics for our Total Cost of Care (TCOC) revenue & expense review process.

This is a 100% Remote position but you must live in EST or CST time zones.

Responsibilities

• Strong technical background and analytical insights
• Strong business knowledge and the ability to work cross-functionally
• Effectively communicate with leadership on market trends and areas of opportunity
• Responsible for recurrent review of a given market/LOBs experience to generate a complete picture of medical/pharmacy expense and revenue trends
• Meet with other business teams on actionability from insights by helping develop High-Value Opportunities (HVOs) that provide savings/revenue added
• Review and validate savings methodologies and estimates for ongoing initiatives

Qualifications

• Bachelor’s Degree in Actuarial Science, Economics, Computer Science, IT, IS, or a related field strongly preferred OR equivalent combination of education and work experience will be considered
• One to three (1 – 3) years of experience working in Medical Informatics, Medical Economics, or related analytical positions at Managed Care Organizations, vendors, or providers
• Technology competencies include Azure Databricks, Python, MS SQL Server, Tableau, MS Power BI, Excel Data Models or equivalent technologies

Requirements

• Knowledge of Medicaid business and familiarity with healthcare domains (claims, UM, etc.)
• Knowledge of health informatics terminology & classification schemes (i.e., CPT codes, ICD-10 dx, common groupers like DRGs, CCS, etc.)
• Knowledge of industry-standard population health & quality KPIs (i.e., utilization per thousand, readmission rates, HEDIS metrics, etc.)
• Strong experience in SQL, Excel and Power BI
• Excellent communication skills

Benefits

• Flexible work solutions including remote options, hybrid work schedules
• Competitive pay
• Paid time off including holidays and volunteer events
• Health insurance coverage for you and your dependents on Day 1
• 401(k)
• Tuition reimbursement
• And more