Medical Economics Consultant (Pop Health/Clinical Analytics) - REMOTE

Molina Healthcare; Miami (FL); Remote; USD 80,000 - 135,000; Full time

Job summary

A healthcare organization in Miami is seeking a Medical Economics Consultant to provide consultative support and medical cost-based analysis. You will manage multiple projects, analyze data for risks and opportunities, and assist in strategic decisions. Candidates should have a Bachelor's Degree in a relevant field and 5-7 years of experience in the healthcare industry, focusing on provider contracting and reimbursement. The position offers a competitive salary between $80,412 and $135,000 annually.

Benefits

Competitive benefits package

Qualifications

• 5 - 7 years in healthcare or managed care industry.
• Knowledge of provider contracting and reimbursement.
• Ability to manage and analyze large data sets.

Responsibilities

• Provides consultative support and medical cost-based analysis.
• Manages conflicting priorities and multiple projects.
• Delivers analysis results to senior leadership.

Skills

Data analysis

Data visualization

Medical cost analysis

Project management

Excel

MS-Access

Education

Bachelor's Degree in Finance, Mathematics, Statistics, or Economics

Master’s Degree in Business Administration, Finance, Mathematics, or Economics

Job description

Overview

Job Description

Provides consultative support and medical cost-based analysis of markets and network initiatives. The Medical Economics Consultant manages conflicting priorities and multiple projects concurrently. Responsible for extracting, analyzing, and synthesizing data from various sources to identify risks and opportunities as well as packaging and delivering the results to senior leadership. Responsible for consulting with network and clinical management on opportunities to improve our company’s discount position and strategic cost and utilization initiatives.

Responsibilities

• Provides consultative support and medical cost-based analysis of markets and network initiatives.

• The Medical Economics Consultant manages conflicting priorities and multiple projects concurrently.

• Responsible for extracting, analyzing, and synthesizing data from various sources to identify risks and opportunities as well as packaging and delivering the results to senior leadership.

• Responsible for consulting with network and clinical management on opportunities to improve our company’s discount position and strategic cost and utilization initiatives.

Knowledge/Skills/Abilities

• Analyze and research utilization and unit cost medical cost drivers

• Turn data into usable information by tell the story through data visualization working with clinical, provider network and other personnel to bring supplemental context and insight to data analyses

• Support the development of scoreable action items by identifying outlier cost issues

• Perform drill-down analysis to identify medical cost trend drivers; advise network of contracting opportunities to mitigate future trends

• Own, track and document all aspects of related work from beginning to end of a project

• Extract and compile information from various systems to support executive decision-making

• Ability to mine and manage information from large data sources

• Working with Excel, MS-Access and Web-based query tools (data warehouse)

Qualifications

REQUIRED EDUCATION:

Bachelor's Degree in Finance, Mathematics, Statistics, or Economics

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:

5 - 7 years in healthcare/managed care industry with knowledge of provider contracting, provider reimbursement, patient management, product, benefits design, or related experience.

PREFERRED EDUCATION:

Master’s Degree in Business Administration, Finance, Mathematics, or Economics

PREFERRED EXPERIENCE:

Experience working with medical and pharmacy claims, authorization data, benefits design, medical management as well as knowledge of business functions and impact on financials (underwriting, sales, product development, network management.)

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $80,412 - $135,000 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.