Medical Economics Consultant - Medicaid Segment C2V

Description

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JOB SUMMARY

This job is responsible for using medical cost analytics to provide fact based strategic insights into emerging medical cost trends. Using large sets of data, the ideal candidate will create the story of medical cost trends in a way that is clear, concise and easily understandable. The incumbent will have proven detailed technical and analytical experience with strong communication and influencing skills. More specifically, will engage with matrix partners to develop the medical cost analytics to determine the value of business solutions. Using data driven analytics, the ideal candidate will: 1) develop the value of the programs, 2) track the outcomes of the programs, and 3) provide strategic insight into areas of focus/opportunities.

This is a hybrid based role in Pittsburgh, PA. You will be required to be onsite 3 days a week. T, W, Th. The ideal candidate for this role will have medical and pharmacy claims data experience.

ESSENTIAL RESPONSIBILITIES

• Provide strategic/tactical insights into emerging medical cost trends. Develop executive ready presentations explaining analytical findings in a clear concise manner.
• Proficiency to extract, summarize and analyze large datasets via SAS, SQL or other similar tools.
• Provide business areas with opportunity assessments of their strategic medical cost programs. Coordinate savings opportunity projections and post implementation savings measurements. Develop improved business case and savings estimate capabilities to enable more accurate and deeper projections.
• Leverage analytical experience and knowledge to drive independent medical cost analytics; develop areas of opportunity using a fact-based analysis, present medical cost analytics and insight into claim cost drivers to key business partners.
• Strong communication skills (verbal and executive quality presentations) to present clear, concise presentations of the detailed analytics.
• Work in a matrixed work environment. Partner with other departments in developing the full analytical story.
• Other duties as assigned or requested.

EDUCATION

Required

• Bachelor's Degree in Business, Health, Economics, Mathematics/Actuarial Sciences or other related area

Substitutions

• None

Preferred

• Master's Degree in Business, Health, Economics, Mathematics/Actuarial Sciences or other related area

EXPERIENCE

Required

• 5 years of Medical Economics, Healthcare Analytics, Informatics and/or Actuarial Services in the health care payer sector

Preferred

• None

LICENSES AND CERTIFICATIONS

Required

• None

Preferred

• None

SKILLS

• Proven analytical ability to drive independent work and meet business timelines and outcomes.
• Strong Technical Data Skills (SAS / SQL, R, Tableau, Excel, etc.)
• Demonstrated ability to work with business partners in communicating outcomes, partnering on analytics, and developing new approaches to breaking down a strategic hypothesis.
• Experience in the healthcare Industry, with solid knowledge of emerging trends and challenges

Languages (Other then English)

None

Travel Required

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-Based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Rarely

Lifting: 25 to 50 pounds

Never

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