Company Statement

For the last 80 years, EmblemHealth has been taking care of New York’s heart and soul, its people. Today, health care is more complex than ever. That’s why we’re at the forefront of change. We work alongside our customers to offer access to high-quality, affordable care, help navigate the health care experience, and make good health achievable; because everyone deserves to be taken care of. We deliver on our mission every day by living our values with our colleagues, members, clients and partners. It begins with caring and respecting all those we work with. We believe a culture of diversity and inclusion is vital to serve our unique and diverse customers. We seek for continues improvement and innovation and believe being agile and nimble is our advantage. We bring a strong sense of partnership to every relationship – internally and externally. The EmblemHealth family of companies offers competitive health, welfare, and retirement benefits as well as incentive pay plans and more.

Medical Economics Analyst

📁
Manager & Professional
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190QW Requisition #
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Will extract, analyze and interpret data to produce both standard claims and utilization trend reporting and ad hoc analysis requests. Supports all functions within Medical Economics including monitoring of specific corporate and health cost containment initiatives.

 

Responsibilities:

  • Supports research and analysis of financial data, draws conclusions and provides consultation to internal and external partners for use in administering specific programs and processes related to medical expense and utilization.

  • May create comparative views of unit cost information that contracting teams can utilize to identify outlier contracts.

  • Conducts ongoing monitoring of medical cost savings initiatives.

  • Assist the business units to identify trend outliers, analyze the trend drivers and perform the work necessary to facilitate the discussion on possible solutions.

  • Performs detailed analyses, including accumulation of data, financial modeling, and reporting of outcomes.

  • May provides detailed analytics to provider network contracting teams in support of the negotiation process.

  • Develops ad hoc views of data that illustrates underlying trend issues for both cost and utilization.

  • Performs additional duties as assigned.

Required:

  • BA/BS Required in Mathematics, Economics, Healthcare or other quantitative discipline.

  • 3-5 years of experience working in a healthcare setting either within a provider health system or health insurance company required

  • Strong knowledge of and experience working with healthcare data including but not limited to claims, testing results and pharmacy data required

  • Preparing dashboards and preparing and presenting data using a data visualization tool such as Tableau preferred

  • Strong data querying skills using tools such as SQL or SAS Enterprise Guide preferred

EEOC Statement

We are committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law.

Sponsorship Statement

Depending on factors such as business unit requirements, the nature of the position, cost and applicable laws and regulations, EmblemHealth may provide work visa sponsorship for certain positions.

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