Identify and quantify medical cost, utilization, and risk adjustment opportunities that drive performance improvement across the client base
Contribute to projections and evaluations of the financial impacts of new or existing programs and solutions on cost outcomes and service utilization
Operate in a dyad partnership with the Manager of Population Health Analyst to coordinate cost and clinical/quality insights
Engage regularly with internal and external stakeholders across clinical, operational, and executive teams to provide meaningful insights
Serve as a trusted advisor, translating complex data into actionable recommendations to enable financially sustainable care and performance improvement
Lead a small team, providing guidance and support for analysts and creating a collaborative team environment
Lead complex analyses focused on medical cost trends, utilization patterns, financial performance, and risk adjustment
Identify actionable opportunities to increase appropriate utilization and optimize cost of care
Create opportunity assessments, driver analyses, dashboards, and other products to extract meaningful insights
Translate insights into strategic recommendations for internal stakeholders and clients
Develop and monitor key performance indicators of costs, utilization, and risk adjustment performance
Develop, contribute to, and implement best practices and standards; ensure data and analysis quality and alignment with enterprise standards
Create a culture of continuous improvement and accountability, setting clear expectations and empowering team members to achieve high performance
Requirements
Bachelor’s degree in a relevant field—e.g., economics, actuarial science, finance, statistics, data science, applied mathematics, economics, business analytics, etc.
Master’s degree strongly preferred
7+ years performing medical economics analysis in a payer, health system, and/or provider setting
1-2 years of people leadership experience is required, 3 years strongly preferred
High proficiency in SQL and statistical programming (SAS, R, Python, etc.)
Experience and expertise with data visualization tools, healthcare data platforms, cost of care tools, and cost and utilization benchmarks
Broad and deep expertise in the analysis of medical and pharmacy claims data, drivers of unit costs and utilization of care, total cost of care, and risk adjustment
Strong project management skills and ability to lead through influence
Exemplary written, verbal and storytelling communication skills, with the ability to effectively share complex information with a variety of audiences
Codes efficiently, validates work rigorously, and aligns analysis with role complexity