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Medical Economics Analyst

axialHealthcare is seeking an experienced, healthcare analyst with strong SQL skills, who can provide enterprise-wide technical, operational, reporting, and analytical expertise.  Ideally, this is an extremely analytical, individual-contributor role requiring initiative, independence and drive, an ability to work in a dynamic, fast-paced environment, and an ability to perform a wide variety of duties.  As an analytical specialist, this role will provide critical standard and ad-hoc business analysis and reporting of metrics. Our ideal candidate has the ability to work on multiple projects simultaneously with minimal supervision and must be able to quickly adapt to changes in both technology and business environments. The Medical Economics Analyst must be highly self-motivated, directed and must possess a positive attitude and strong customer services skills. For someone to be successful in this role, they must have the ability to analyze data and apply investigative skills in resolving issues for our client partners.

Position Responsibilities:

  • Design and conducts analyses to evaluate the overall effectiveness of Axial’s core programs including achieving financial and utilization goals.  Develop data queries, conduct rigorous analyses using appropriate statistical methods, interpret results and present findings to leadership.
  • Develop and maintain savings models that account for risk adjustment, continuous enrollment, seasonality, trends, etc
  • Develop intimate knowledge of customer nuances, regional variations, legislative changes etc that can be leveraged in analytical value delivery.  Establish and maintain effective relationships with customers and gain their trust and respect.
  • Support efforts to design, implement, and execute alternative payment arrangements and risk/incentive structures with customers.
  • Analyze and interprets cost and utilization data, identify key drivers, and underlying issues, perform appropriate drill down queries, summarizes, present and translate findings into meaningful information and actionable results.
  • Assist in quality control analysis to ensure client satisfaction and performance guarantees are met and/or exceeded.
  • Produce ad hoc, monthly, quarterly and annual reports and analyses.
  • Execute prospective client analyses with focus on identifying specific opportunities and assisting related business development activities.
  • Monitor the accuracy, completeness and validity of reporting prior to distribution and ensure the integrity of data through ongoing analysis.
  • Collaborate with the Data Warehouse team on the data architecture necessary to support recurring and ad-hoc claims-based financial impact analyses

Position Requirements:

  • Bachelor’s degree in a quantitative field.  Masters preferred.
  • 1-4 years of experience in the healthcare industry.
  • Expertise in developing complex, legible and well-structured scripts and queries in SQL, SAS or R
  • Analytical experience with claims, provider, eligibility, and related data.
  • General knowledge of health policy, Medicaid and Medicare
  • Experience in data mining and analytic data transformation of large data repositories and/or relational databases.
  • Advanced analytic skills with the ability to analyze and interpret data through complex analysis.
  • Excellent computer skills, organization, and project management skills.
  • Demonstrated progress towards actuarial certification a plus
  • Prior pricing analysis experience / financial modeling experience highly desired
  • Medical cost savings experience in a Health plan highly desired