CSI Companies is seeking a Medical Ecomonics Analyst to work with one of our top healthcare clients!

Title: Medical Economics Analyst

Location: Jacksonville, FL 32207

Type: Hybrid (On-site Monday - Wednesday; Remote Thursday & Friday)

Salary: $90,000 - $100,000 annually

Summary:

Medical Economics Analyst / Senior Analyst will be responsible for working with Medicare Advantage and DCE membership files to produce panel reports, identify new and termed members, and other Medicare Advantage/DCE membership reporting.

Essential Responsibilities:

Must be proficient in using SQL Server
Consolidates monthly patient rosters from payers and disseminates standardized list to various departments (Value Based, Finance, Market Clinical Operations, etc.).
Develops monthly process to identify new and termed members and work across multiple data systems to consolidate demographic details.
Communicates with operational teams to meet their data and reporting needs.
Tracks business requirements from payers regarding cost reallocations and monitors case outcomes.
Develops monthly processes and procedures for identifying candidates for potential cost reallocations and completes accompanying forms, if applicable, for payer submission.
Obtain and analyze data to understand how to continually improve processes, procedures and execution.
Maintain knowledge of current healthcare trends by reading appropriate literature and attending related conferences and/or seminars.
Relied upon applying business knowledge to analytics projects and provide value-added insights to directly impact business outcomes.

Qualifications:

Proficient in using SQL Server is a must
Excellent written and verbal communication skills and ability.
Proficient in Microsoft Office such as Excel, Word, Access, etc.
Experience with using Power BI strongly preferred.
Strong analytical, organizational, and problem-solving skills.
Experience working with complex data sets across claims, lab, financial, clinical outcomes, and external sources.
Knowledge of medical data structures including, but not limited to (ICD10, CPT, HCPCS, NDC)
Knowledge of different reimbursement models (DRG, APC, AWP+, Cost plus, PDGM)

Minimum Requirements:

Bachelor's degree in Business, Health Care Administration, Mathematics, Finance, Health Informatics, or related field.
Proficient in SQL Server and Microsoft Suite
Requires 1- 2+ years of experience in healthcare-related data analysis is strongly preferred.
Masters in relevant field preferred and can be substituted for 2 years' experience.

CSI Companies

New Jobs

Medical Economics Analyst