Healthcare Economics Analyst Job Description
Healthcare economics analyst
provides consultation and training related to data collection, management, analysis and reporting across a variety of data platforms including Business Objects, Epic, Excel, Tableau and the Vizient Clinical Database.
Healthcare Economics Analyst Duties & Responsibilities
To write an effective healthcare economics analyst job description, begin by listing detailed duties, responsibilities and expectations. We have included healthcare economics analyst job description templates that you can modify and use.
Sample responsibilities for this position include:
Interpret and analyze data from various sources using knowledge of healthcare administrative claims data and advanced SQL coding skills
Relate analytic findings to business questions and objectives
Responsible for utilizing all data mining tools
An understanding of healthcare payment methodologies and policies coding is recommended
Interpret and analyze claims, premium, capitation and membership data in support of Actuarial and utilization analyses
Understanding of Medicare Advantage reporting needs and star ratings preferred
Identifies, organizes, and analyzes qualitative and quantitative clinical, financial, operational, psycho-social, demographic, and administrative data from multiple sources, and synthesizes results, measurements, and key performance metrics into meaningful reports and presentations
Under the direction of Business Analytics leadership , designs, develops, and implements standardized methods for quantifying and clearly articulating qualitative information, including root causes, potential inflection opportunities, and solutions for key business problems relating to the data
Employs existing complex models and implements them on new projects and/or in new contexts, and s/he designs new solutions for data nad analytic challenges the organization faces
May develop particular areas of expertise with respect to certain types of data (clinical, financial, operational, other), and over time will manage increasing levels of complexity and sophistication in data and types of data, so as to suggest new tools for supporting decisions within our organization or with external stakeholders
Healthcare Economics Analyst Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Healthcare Economics Analyst
List any licenses or certifications required by the position: CCSP, AHIMA
Education for Healthcare Economics Analyst
Typically a job would require a certain level of education.
Employers hiring for the healthcare economics analyst job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Master's Degree in Economics, Statistics, Finance, Math, Accounting, Mathematics, Business, Actuarial Science, Healthcare Administration, Health
Skills for Healthcare Economics Analyst
Desired skills for healthcare economics analyst include:
Claims processing
Healthcare industry
Managed care contracts and principles and concepts of statistical analysis
Healthcare claims processes and procedures
Tableau
Database platforms
Query tools
System platforms and software packages platforms
Data mapping/ETL
SQL
Desired experience for healthcare economics analyst includes:
Intermediate level of proficiency working with MS Excel including formulas, calculations, charts, graphs
3+ years of relevant work experience in a corporate setting
Proficiency in data analytics and / or financing modeling
VB / VBA programming experience
Proficiency in data analytics and/or financial modeling
Beginner level proficiency in performing data analytics
Healthcare Economics Analyst Examples
1
Healthcare Economics Analyst Job Description
Job Description Example
Our company is growing rapidly and is searching for experienced candidates for the position of healthcare economics analyst. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for healthcare economics analyst
- Interpret and analyze claims, membership, and authorization data in support of cost trend analysis clinical program performance evaluation
- Act as a liaison across CHI functional areas to update payer contract rate information and communicate changes
- Oversee and prepare complex payer contract reimbursement analyses and financial performance analyses
- Identify, collect, and manipulate data within multiple contract modeling tools, billing systems, and databases (e.g., Payment Integrity Compass, EPSI, EPIC) and external sources (e.g., Medicare/Medicaid website)
- Assess risk/exposure associated with various reimbursement structure options and develop models, reports and tactics to ensure compliance with contracted reimbursement structures
- Prepare and effectively present results to Payer Strategy & Operations leadership, and other key stakeholders, for review and strategic planning activities
- Maintain knowledge of industry trends, payer policies and protocols, and revenue cycle operations to support effective contract compliance activities
- Prepare routine reports and ad-hoc analyses as directed, with ability to accurately reflect actual vs
- Reviews and evaluates the language of the Managed Care contracts and participates in negotiations, as needed
- Must be able to travel to other company sites or business functions, as needed
Qualifications for healthcare economics analyst
- Medicaid experience is preferred but not required
- Must be able to work well under tight deadlines, and be able to manage multiple competing priorities
- Advanced degree in Mathematics, Statistics, Economics, Computer Science, or a related quantitative discipline
- Advanced or higher level of proficiency with MS Excel (including formulas, calculations, charts, graphs)
- Bachelor's Degree in Healthcare Administration, Actuarial Math, Statistics, Economics, or a related field and/or Equivalent work experience
- Acts as the subject matter expert for producing provider value based contracts reports for end user
2
Healthcare Economics Analyst Job Description
Job Description Example
Our company is growing rapidly and is looking to fill the role of healthcare economics analyst. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for healthcare economics analyst
- Must be able to cross-train and support other regional analysts
- Performs other duties as assigned or as needed by the business
- Work cross-functionally with Product Managers, Medical Affairs, Clinical Affairs, Regulatory Affairs, Data Scientists, and outside consultants to drive the scoping and execution of new projects
- Serve as the liaison between our internal and external stake holders, ensuring high quality, on-time deliverables, pro-active communication, and efficient issue resolution
- Create and deliver internal and external content, including presentations, agendas, minutes, and reports
- Coordinate and manage all deliverables, milestones and deadlines related to assigned studies/projects, including HCE and Outcomes deliverables, consultant deliverables, and clinical informatics work
- Provide cross-functional internal teams with the information and tools needed to ensure their ability to launch and support HCE and Outcomes projects
- Provide training and implementation/ongoing support to internal team members
- Work with the Product Managers in providing feedback and input to guide strategy roadmap
- Establish, as necessary, and manage processes, key performance metrics to ensure optimal service and operational quality and efficiency
Qualifications for healthcare economics analyst
- Collects and documents report / programming requirements from requestors to ensure appropriate creation of reports and analyses
- Create comprehensive workflows for the production and distribution of assigned reports
- Bachelor's Degree in Finance, Economics, Math, Computer Science
- Telecommuters will be considered
- Bachelor's degree in Finance, Math, Statistics, Actuarial Science, Economics, or a related field
- Proficient with MS Excel to include pivot tables, foundational formulas, charts
3
Healthcare Economics Analyst Job Description
Job Description Example
Our company is growing rapidly and is searching for experienced candidates for the position of healthcare economics analyst. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for healthcare economics analyst
- Collaborate cross-functionally with key partners to support internal decision-making in brand planning and life cycle initiatives with regards to health economics and outcomes issues
- Attend off-site meetings and conferences, as needed
- Design, develop, and implement quantitative analyses on drivers of health care costs and utilization using integrated health care datasets to support population health analytics
- Provide ad hoc analysis and reporting for leadership leveraging Monarch’s robust data warehouses to demonstrate clinical and financial outcomes
- Provide claims, revenue, capitation and membership data in support of Underwriting, Actuarial and utilization analyses
- Create databases, statistical modeling and financial reports
- Complete other ad-hoc projects as needed
- Experience analyzing financials related to Health Care Claims, Health Care Products, and/or Pharmacy Underwriting
- Knowledge of underwriting principles in a managed care environment
- Strong organizational skills and must be able to adhere to strict deadlines
Qualifications for healthcare economics analyst
- At least an intermediate level of proficiency working with Microsoft Excel, including formulas, calculations, pivot tables, charts, graphs
- 3+ years of health care industry reporting experience is highly preferred
- Bachelor’s degree in Actuarial Science, Math, Business/Data Analytics, Data Science or similar degree
- Bachelor’s degree in a field that relies on quantitative analysis
- Post-graduate degree in a field that relies on quantitative analysis and/or healthcare policy and analysis
- 2+ years of work experience in a corporate setting or in an advanced degree program
4
Healthcare Economics Analyst Job Description
Job Description Example
Our company is growing rapidly and is searching for experienced candidates for the position of healthcare economics analyst. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for healthcare economics analyst
- Research and investigate key business problems through quantitative analyses on drivers of health care costs and utilization using integrated health care datasets
- May create training and deliver education programs to sales force, physicians, home care agencies, case managers, hospital CFO's, medical directors, billing personnel, and pharmacists in clinics and hospitals
- Produce, review, and present reports to leadership
- Review and tracking for known data issues
- Identification and resolution for unknown data issues
- Making sure incoming data is complete
- Verification of data loaded including quality and reasonable checks
- Development of processes and procedures to improve quality and timeliness of data delivery
- Source data monitoring for potential data quality issues and inconsistencies
- Strong analytical / critical thinking and communication skills
Qualifications for healthcare economics analyst
- Experience in data analysis with a focus on health economics, health policy, or health services research
- Healthcare, insurance or related industry experience preferred
- The nature and scope of this position is to be involved in all aspects of contracts from beginning to end, including the initiation, evaluation, negotiation, re-negotiation implementation, maintenance and termination of contracts
- This position provides a critical liaison and negotiating arm for CHI hospitals and physicians, which as a profound impact on the organization
- This position will serve all stakeholders through on-going educational and problem-solving support
- Requires daily contact with senior management, physician, hospital staff, and managed care company leaders
5
Healthcare Economics Analyst Job Description
Job Description Example
Our company is growing rapidly and is searching for experienced candidates for the position of healthcare economics analyst. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for healthcare economics analyst
- Review and validation of network optimization financial data
- Completion of physician scorecards according to terms of Value Based Contracts and present to Health Plan
- Financial modelling in support of United Health Network requests, following contracting guidelines
- Perform standard model and financial scorecard reviews
- Assist in automation of accruals of Value Based Contracts
- Ability to independently research both internal and external questions and provide input and suggestions for system sustainability, programming, new processes
- Identify payment errors regardless of claim system by reviewing data and possessing claims coding experience
- Identify and refine criteria to successfully increase efficiency of algorithm logic
- Develop a comprehensive understanding of quality, utilization and financial metrics, the technology used for clinical analytics and logistics of the data systems
- Work closely with Informatics and regional OptumCare Healthcare Economics leadership to compile data from multiple sources, complete data analysis and develop consolidated reports and reporting formats that will ensure the optimal understanding and utilization at the provider/practice level in support of successful execution of population health management
Qualifications for healthcare economics analyst
- Must handle adverse politically difficult situations, as managed care negotiations have a direct impact on individual physician incomes, along with directly impacting the financial performance of CHI
- Outside meetings with physicians and senior executive from external payers is frequent
- This person must take accountability for designated reimbursement modules and systems and must be proficient in readying, interpreting and formulating complex computer system rules
- This position provides a critical liaison and negotiating arm for CHI hospitals and physicians, which has a profound impact on the organization
- This position will serve all stakeholders through on-going education and problem-solving support
- This position requires daily contact with senior management, physician, hospital staff, and managed care company leaders