Medical Economics Analyst II

🕒 June 4

🇺🇸 United States – Remote

💵 $72.2k - $115.5k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🧐 Analyst

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 55%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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CareSource

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 30+ years

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

📋 Description

• Identify and quantify cost savings initiatives to reduce medical costs within the markets • Build financial models to quantify the impact of medical cost reduction initiatives • Assess overall health plan performance and perform root-cause analysis of medical cost, utilization trends, risk adjustment dynamics, revenue impacts, utilization management, key drivers, outliers, and optimization opportunities • Extract, manipulate, and validate large healthcare claims and prior authorization datasets using SQL and Microsoft Excel/Power BI • Develop tools to efficiently identify new cost savings opportunities • Partner with various departments to discuss, develop, and solve medical cost reduction initiatives • Define populations, comparison groups, measures, and analytic methodologies to evaluate healthcare programs and interventions • Evaluate the efficiency and effectiveness of clinical programs, interventions, processes, and medical cost reduction initiatives • Present analytical findings and recommendations • Support intake, prioritization, and coordinated execution of ad-hoc analytics requests across the organization • Perform other job duties as requested

🎯 Requirements

• Bachelor’s Degree or equivalent years of relevant work experience is required • Minimum of two (2) years of experience in healthcare analytics is required • Managed care experience is strongly preferred • Advanced knowledge of healthcare data, including medical and pharmacy claims, EMR data, HIE data, UM prior authorization data, care management data, and demographic data • Knowledge of Medicaid, Medicare and other government sponsored healthcare programs is required • Advanced Excel proficiency, including pivot tables, lookups, financial modeling, and data validation • Proficient SQL skills, including complex joins, aggregations, subqueries/CTEs, data validation, and working with large healthcare datasets • Familiarity with generative AI tools and their application to healthcare analytics • Ability to synthesize complex data into clear findings, conclusions, and actionable recommendations • Demonstrated ability to independently investigate healthcare cost and utilization questions, identify key drivers, validate findings, and develop actionable conclusions • Ability to balance competing priorities • Demonstrated written and verbal communication skills

🏖️ Benefits

• Bonus tied to company and individual performance may be available • Substantial and comprehensive total rewards package • Employee total well-being support