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.
Senior Healthcare Economics Analyst
Summary:
- Work with other team leaders to improve operational efficiencies and resource allocations for improved performance of the EmblemHealth plans.
- Responsible for running queries and providing required analysis to understand related drivers (such as medical cost and utilization), and to provide insightful commentary and sensitivity modeling analysis.
- Develop data-driven analysis for decision making on how EmblemHealth purchases, manages, and influences the cost of care for current and prospective members.
- Extract, analyze, and interpret data for more complex insights related to cost drivers and to manage the escalation of issues that impact costs, and impact of health cost containment initiatives.
- Provide consultative subject matter expertise to aligned business areas to demonstrate analytics rooted in data.
Responsibilities:
- Ensure data integrity is maintained throughout the reporting lifecycle.
- Implement reporting and reconciliation workflows and document processes.
- Responsible for experience studies and medical trend studies.
- Perform research and collection of data, including data mining and reporting, which is provided to various customers inside and outside the department.
- Implement automation of manual reporting and analysis of business implications and trends.
- Lead efforts to continually improve data capabilities and quality of department analysis and reporting.
- Create, develop, and design analytics and reporting to measure or estimate financial impact of health plan business problems and potential or actual solutions, addressing escalated issues with subject matter expertise.
- Lead and manage several corporate and health cost containment initiatives, supporting staffing to deliver results across all functions within Medical Economics including.
- Develop research and analytic processes to review financial data to draw conclusions for senior leadership.
- Represent the department to internal and external partners with presentation of data and results for use in administering specific programs and processes related to medical expense and utilization.
- Present analytical findings to internal business partners, leading discussions and providing delivery of further analysis.
- Analyze business problems related to financial experience of the health plan, particularly related to how care is purchased, managed, or other factors influencing cost of care.
- Perform additional duties as assigned.
Requirements:
- BA/BS in Mathematics, Statistics, Economics, Healthcare or related discipline required; Master’s preferred.
- 4 – 6+ years of relevant, professional work experience required
- Experience querying, summarizing, and manipulating data using SQL or SAS required
- High level of proficiency with MS Office (Word, Excel, PowerPoint, Outlook, etc.), with an emphasis on Excel required
- Experience working in a healthcare setting (within a provider health system or health insurance company) preferred
- Experience working with healthcare data including but not limited to claims, testing results and pharmacy data required
- Strong communication skills (verbal, written, presentation, interpersonal) required
- Experience preparing/presenting dashboards and data using a data visualization tool such as Tableau preferred
Security Disclosure
If you are offered a job from one of the EmblemHealth family of companies that includes ConnectiCare, AdvantageCare Physicians, and WellSpark, the offer confirmation email will come from “HRTalentAcquisition” with the subject line: “Offer of Employment for (job title)” – Please respond online”.
We never ask you to join a Google Hangout, request you to purchase your own equipment or pay to apply. We do not send email from a third-party email service such as Yahoo or Gmail.
Pay Disclosure
A good faith estimate of the compensation range for individuals hired to work for the EmblemHealth Family of Companies is provided. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, internal peer equity, and market and business considerations. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. It is not typical for an individual to be hired at or near the top of the range, as compensation decisions depend on each case’s facts and circumstances. Union roles covered by a collective bargaining agreement will compensate in accordance with the union contract.
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/gender, sexual orientation, gender identity or expression, pregnancy or related condition, marital status, 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.