The Manager Analytics, Medical Economics will monitor financial performance and provide analytic insights for all products offered within the Healthfirst portfolio. At times this leader could be called upon to manage the daily operations of high value projects for the company to ensure predetermined goals are met for the project. The ideal candidate will come from a managed care, insurance, actuarial, or hospital background, and will be a results-oriented individual who enjoys working in a fast-paced and challenging environment.
Scope of Responsibilities:
- Monitor cost and utilization trends, provide concise insight into the root cause drivers, and develop potential remediation opportunities.
- Develop savings analyses for Medical Economics cost trend reduction initiatives, applying financial modeling expertise and using independent judgement to determine best valuation methods.
- Provide data driven analysis to Finance, Claims, Medical Management, Network, and other departments to enable critical decision making.
- Create financial models to evaluate the impact of provider reimbursement changes.
- Keep abreast of New York Medicaid and Medicare reforms and their impact on Healthfirst and their owner hospital performance.
- Manage a team of analysts.
- Perform ad hoc analyses.
Minimum Qualifications:
- Bachelor's Degree from an accredited institution.
- At least 4 years of experience in the managed care industry related to analytics.
- Extensive knowledge of managed care financial metrics (PMPM, util/k, cost/unit).
- Experience utilizing healthcare claims data to uncover valuable insights to improve financial performance.
- Experience with SAS or SQL (creates queries and manipulation of data).
- Extensive experience with Microsoft Excel (building financial models, utilizing pivot tables, vlookups, index match, and calculated fields).
- Ability to work with large data sets.
- Strong written and verbal communication skills.
- Experienced in leading a team of analysts.
- Resourceful and creative in solving complex issues and working corroboratively with others on a solution.
- Ability to manage projects and project plans within stated timelines.
Preferred Qualifications:
- 5+ years of experience in the managed care industry related to analytics.
- Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms.
- Understanding of value-based risk arrangements.
- Experience using Tableau.
- Experience mentoring other team members.
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.
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All hiring and recruitment at Healthfirst is transacted with a valid "@healthfirst.org" email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.
Hiring Range:
- Greater New York City Area (NY, NJ, CT residents): $108,300 - $156,485
- All Other Locations (within approved locations): $95,300 - $141,780
As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.
In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.
The hiring range is defined as the lowest and highest salaries that Healthfirst in "good faith" would pay to a new hire, or for a job promotion, or transfer into this role.