Medical Economics Analyst

Job ID: J132233
Company: Highmark Inc
Location: Pittsburgh, PA, United States
Full/Part Time: Full time
Job Type: Regular
Posted at: Sep 27, 2018

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Description

JOB SUMMARY

This job analyzes emerging medical cost trends, develops medical cost analytics, builds analytics models, and tracks outcomes related to the initiatives focused on medical costs.  The incumbent leverages medical economics processes, tools, and reporting. The incumbent also supports the team to help business leaders link their programs with financial plans/forecasts, emerging results, and outcomes. Additionally, the incumbent builds business segment medical economic analytics to help tell the story of emerging financial results. Incumbent must demonstrate a high-level of analytical, communication, and influencing skills.

ESSENTIAL RESPONSIBILITIES

  • Analyze emerging medical cost trends to understand the larger medical cost picture to provide timely insight into claim cost drivers for the business segment leaders and identification of new improvement opportunities.
  • Use medical economics and analytical experience and knowledge to facilitate idea generation and quantification of savings initiatives in areas of focus, such as provider contracting, utilization management, care management, risk adjustment, operational efficiencies, product design, etc.
  • Influence other departments without direct authority in coordination with other team members.  Determine when projections seem unreasonable and constructively push back until satisfied with the analysis.
  • Consistently work with Health Plan business and functional area partners to develop a pipeline of new initiatives, seeking to achieve our multi-year financial improvement targets. Help drive a culture change from “reporting the past” to “creating the solutions for future.”  
  • Develop improved business case and savings estimate capabilities to enable more accurate and deeper projections.
  • Other duties as assigned or requested.

EDUCATION

Required

  • Bachelor's Degree in Business Administration/Management, Economics, Mathematics, Actuarial Science, Finance, or Accounting

Substitutions

  • None

Preferred

  • None

LICENSES & CERTIFICATIONS

Required

  • None

Preferred

  • None

EXPERIENCE

Required

  • 3 years of progressive experience in Medical Economics, Healthcare Underwriting, Finance, Accounting, or Analytics

Preferred

  • None

SKILLS

  • Medical Economics   
  • Underwriting   
  • Financial Analysis/Modeling   
  • Communication   
  • Collaboration across a matrix-environment   
  • SAS/SQL or other data querying experience   

Travel Required

0% - 25%

Language Required (other than English)

None

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

Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
 

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/ProtectedVeterans/Disabled/Sexual Orientation/Gender Identity (http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf)
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.
For accommodation requests, please call HR Services at 844-242-HR4U or visit HR Services Online at HRServices@highmarkhealth.org

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