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.
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.
BA/BS Required in Mathematics, Economics, Healthcare or other quantitative discipline
3-5 years of business experience, preferably in the healthcare industry; proficiency with Excel & SAS/SQL
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
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.
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.