REMOTE - QAI Medical Economics Analyst II - R11936

Job SummaryThe Medical Economics Analyst II is responsible for analyzing healthcare utilization to identify patterns, variation, and outliers as well as identify and quantify opportunities to reduce medical costs.Essential FunctionsIdentify, quantify and model opportunities to reduce medical costs within the marketsEvaluate the effectiveness of medical cost reduction initiativesUnderstand and calculate basic healthcare KPI’sComplete analytic process from start to finish and provide recommendations on medical cost savings initiativesAnalyze healthcare utilization to identify patterns, variation, and outliersDevelop tools to efficiently compare market performance across and within productsMonitor the efficiency and efficacy of clinical programs, interventions and processesSupport the intake, prioritization and coordinated execution of ad-hoc analytics requests from departments across the organizationIdentify the variables and methodologies (e.g., qualitative, quantitative, spatial) that define population cohorts that can be positively impacted through targeted programs and interventionsProduce and maintain quarterly forecast projections for medical cost initiative reductionsPerform any other job duties as requestedEducation And ExperienceBachelor’s Degree or equivalent years of relevant work experience is requiredMinimum of two (2) years of experience in healthcare analytics is required, health plan preferredManaged care experience is strongly preferredCompetencies, Knowledge And SkillsKnowledge of healthcare data, including medical and pharmacy claims, EMR data, HIE data, UM data and demographic dataKnowledge of Medicaid, Medicare and other government sponsored healthcare programs is preferredBasic ability to analyze and interpret financial data in order to incorporate into analyses/reportsProficient in Excel (Power Query, Power Pivot), Word and PowerPointProficient with Transact-SQL or Microsoft Power BIStrong critical thinking skillsAbility to organize data in a way that facilitates inferences, conclusions and decisionsDemonstrated written and verbal communication skillsLicensure And CertificationNoneWorking ConditionsGeneral office environment; may be required to sit or stand for extended periods of timeCompensation Range$72,200.00 - $115,500.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.Compensation TypeSalaryCompetencies Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the BusinessThis job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.