Senior Medical Economics Analyst

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Ennoble Care

WebsiteLinkedInAll Job Openings

201 - 500 employees

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 Non-profit

Healthcare • Healthcare Insurance • Non-profit

Ennoble Care is a community-based primary, palliative, and hospice care service dedicated to providing care to patients and families. With a mission that emphasizes the honor of caring, Ennoble Care operates across multiple states, including New York, New Jersey, Maryland, DC, Virginia, and Georgia, staffed by licensed clinicians who are committed to delivering exceptional care.

📋 Description

• Develop and maintain sophisticated risk-adjusted provider group performance models using CMS-HCC methodology • Analyze value-based care performance under CMS and CMMI total cost-of-care models • Monitor and forecast financial performance across assigned patient populations • Conduct claims analysis using CCLF and BCDA datasets, including simulating CMS-HCC risk adjustment • Process and analyze large healthcare datasets from EHR systems, Medicare claims, and multiple data sources • Ensure data quality and integrity across analytical processes • Create analytical reports translating complex actuarial findings into actionable business insights • Develop executive dashboards and performance metrics aligned with organizational goals • Present findings and recommendations to leadership teams and clinical stakeholders • Support budget planning and financial forecasting • Stay current with CMS and CMMI program requirements and quality measures • Collaborate with revenue cycle and coding teams to optimize documentation and billing accuracy

🎯 Requirements

• Bachelor's degree in Data Science, Statistics, Mathematics, Economics, Business Administration, or related quantitative field • 3-5 years of data analytics experience, preferably in healthcare or Medicare-focused environments • Thorough understanding of and hands-on experience with Medicare risk adjustment and CMS-HCC models • Demonstrated experience working with CMS and CMMI total cost-of-care ACO programs • Proven track record analyzing Medicare claims data, specifically CCLF and BCDA datasets • In-depth knowledge of healthcare billing processes from both provider and CMS perspectives • Advanced proficiency in Microsoft Excel, including pivot tables and complex formulas; VBA preferred • Strong SQL skills, including writing complex queries and optimizing database performance • Experience with Microsoft Azure cloud platform and related analytics tools • Proven ability to work with very large datasets and combine data from multiple sources • Experience integrating EHR data with claims datasets for population health analysis • Exceptional analytical and problem-solving capabilities • Strong business acumen and ability to translate technical findings into strategic recommendations • Excellent written and verbal communication skills for technical and non-technical audiences • Collaborative approach to cross-functional projects • Ability to understand and respond to evolving business needs • Ability to work with sensitive healthcare information and maintain strict confidentiality in accordance with HIPAA and applicable regulations • Candidates must disclose any current or future need for employment-based immigration sponsorship before an offer is extended

🏖️ Benefits

• Medical, Dental, Vision and supplementary benefits such as Life Insurance, Short Term and Long Term Disability, Flexible Spending Accounts for Medical and Dependent Care, Accident, Critical Illness, and Hospital Indemnity • Paid Time Off • Paid Office Holidays • Paid Sick Time • 401(k) with up to 3% company match • Referral Program • Payactiv: pay-on-demand. Cash out earned money when and where you need it!