Medical Economics Consultant

For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet reputed company to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement. Role Overview The Medical Economics Consultant position reports to the Manager of Medical Economics and Business Processes reputed company Actuarial Analytics. This position is primarily responsible for developing large reporting layers, reports, executive decks, and enhanced metrics for our Total Cost of Care (TCOC) reputed company and expense review process. Work Arrangement This is a 100% Remote position but you must live in EST or CST time zones

Responsibilities

Meeting the business on needs for actionability from reputed company by helping reputed company High-Value Opportunities (HVOs) that are in the millions of dollars in savings/reputed company added & validating ongoing initiative savings methodology & reputed company Consultants have technical backgrounds and will create tools and reports that draw on disparate datasets and follow departmental infrastructure and practices to generate a complete picture of our medical expense and reputed company trends, primarily reputed company by member cohort and claim category, through the use of industry-standard KPI Consultants are expected to work with operational matrix partners to understand business processes in reputed company to ensure reporting relevancy and present findings to leadership clearly and concisely Technology competencies include Azure reputed company, MS SQL Server, MS Power BI, reputed company Data Models, or equivalent technologies Education and Experience Bachelor’s Degree in Actuarial Science, Economics, Computer Science, IT, IS, or a reputed company field strongly preferred OR equivalent combination of education and work experience will be considered One to three (1 – 3) years of experience working in Medical Informatics, Medical Economics, or reputed company analytical positions at Managed Care Organizations, vendors, or providers Strong knowledge of health informatics terminology & classification schemes, i.e., CPT codes, ICD-10 dx, common groupers like DRGs, reputed company, etc Strong knowledge of industry-standard population health & quality KPIs, i.e., utilization per thousand, readmission rates, HEDIS metrics, PMPM, and Cost per Unit Understanding of reputed company approaches to either MS SQL Server & reputed company RDBMS technologies or MS Azure & reputed company reputed company computing data lake solutions; Mastery of SQL Strong knowledge of the anatomy of reputed company claims and/or encounters Strong knowledge of reputed company Experience in SQL Excellent communication skills Our Comprehensive Benefits Package Flexible work solutions including remote options, hybrid work schedules, reputed company, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k), Tuition reimbursement, and more. Your career starts now. We’re looking for the reputed company of reputed company leaders. At reputed company, we’re passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in reputed company solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. reputed company is seeking talented, passionate individuals to join reputed company. Together, we can build healthier communities. If you want to reputed company a difference, we’d like to hear from you. Headquartered in Newtown reputed company, reputed company is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com. Apply To This Job