Data Analyst IV Medical Economics

Job Title : Data Analyst IV Medical Economics

Location : Remote, USA (No HI or AK)

Schedule : Must support CST / EST hours

PST candidates must work 6 AM 3 PM PST

Position Type : Full-Time, Permanent

Industry : Healthcare Medical Economics

Salary Range : $100,000 $110,000 / year

Bonus : 8% target

Sponsorship : Not available

Relocation : Not available

About the Role

We are seeking an experienced Data Analyst IV Medical Economics to join our growing Medical Economics team. This role will focus on healthcare financial analytics, payment methodologies, and large-scale data analysis for Medicare, Medicaid, and Marketplace programs. The ideal candidate has strong SQL, Excel, and Power BI expertise, along with a background in managed care analytics.

Key Responsibilities

Analyze large healthcare datasets to support Medical Economics, Managed Care, and financial modeling initiatives.

Develop complex SQL queries to extract, validate, and transform data for reporting and analytics.

Build dashboards, models, and data visualizations using Excel , Power BI , and related tools.

Conduct analyses related to :

Medicare, Medicaid, Marketplace programs

Medical Loss Ratio (MLR)

Quality & Affordability Initiatives (QAI)

Key performance indicators (KPIs)

Apply knowledge of healthcare payment methodologies, including :

DRG pricing

APC

EAPG

Collaborate with cross-functional teams including Finance, Actuarial, and Operations to support strategic decision-making.

Perform data validation, quality checks, and financial sizing to ensure accuracy and integrity of analysis.

Provide insights, recommendations, and reports to support business strategies and cost containment efforts.

Required Qualifications

Bachelor s degree in Business, Economics, Statistics, Mathematics, Actuarial Science, Public Health, Health Informatics, Healthcare Administration, Finance, or related field.

Master s degree preferred

Without a bachelor's degree : minimum 9 years experience

5+ years of experience working with :

Large databases

Data verification

Data management

Advanced SQL skills , including writing complex queries and multiple JOIN types.

Advanced Excel skills , including :

Pivot Tables

Power Query

VLOOKUP / XLOOKUP

Financial modeling

Creating / nesting formulas

Power BI experience , including DAX and Power Pivot.

Strong understanding of healthcare payment methodologies (DRG, APC, EAPG).

Preferred Qualifications

Experience with Python or R for statistical analysis or automation.

Actuarial experience or exposure to actuarial models.

Consulting experience in managed care or medical economics.

Additional Information

This is a newly created position as part of an expanding Medical Economics team.

Candidates with blended actuarial and managed care analytics backgrounds are strongly encouraged to apply.

Maximum salary budget is $110k .