Analyze Medicare, Medicaid, and Marketplace data to support medical cost, utilization, and reimbursement insights
Develop and maintain complex SQL queries to extract, validate, and analyze large datasets
Perform financial and medical cost analyses related to payment and reimbursement methodologies (DRG, APC, EAPG)
Build and maintain Power BI dashboards using DAX and Power Pivot to track KPIs, MLR, and QAI initiatives
Create advanced Excel models using Pivot Tables, Power Query, nested formulas, and lookups to support financial modeling
Collaborate with Medical Economics, Actuarial, Finance, and other cross-functional teams
Support evaluation of Quality & Affordability Initiatives (QAI) and Medical Loss Ratio (MLR) performance
Ensure data accuracy through validation, reconciliation, and documentation

Requirements

Bachelor’s degree in business, economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance, or related field
Equivalent experience considered
4+ years of experience working with large datasets, data management, and analytics OR 2+ years of IT/data-focused experience with healthcare exposure
Strong experience in Managed Care / Medical Economics analytics
Demonstrated knowledge of payment and reimbursement methodologies (DRG, APC, EAPG)
Advanced SQL skills (complex SELECTs, multiple JOINs, subqueries)
Advanced Excel skills (Pivot Tables, Power Query, VLOOKUP/XLOOKUP, financial modeling)
Power BI experience, including DAX and Power Pivot

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

SQLDAXPower PivotExcelPivot TablesPower Queryfinancial modelingdata analysisdata validationdata reconciliation

Soft Skills

collaborationcommunicationanalytical thinkingproblem-solvingattention to detail