Medical Economics Analyst

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🔥 5 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

💵 $130k - $145k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

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Health Network One

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1999

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 B2B

Healthcare • Healthcare Insurance • B2B

Health Network One is a healthcare network management company that partners with health plans to manage specialty outpatient services (including outpatient therapy, routine and medical eye care, dermatology, and podiatry) under full-risk arrangements. The company operates nationally, covering over 7 million lives and contracting with tens of thousands of providers, and offers delegated services such as utilization management, credentialing, claims and network management. Health Network One emphasizes value‑based solutions, clinical quality, cost reduction for professional and facility spend, and holds NCQA accreditation and HITRUST CSF certification.

📋 Description

• Identify, quantify, and model opportunities to reduce medical costs across markets, products, and lines of business • Evaluate the effectiveness and financial impact of medical cost containment and clinical programs • Own the full analytic lifecycle, including data sourcing, validation, modeling, interpretation, and recommendations • Analyze drivers of specialty spend across vision, dermatology, therapy, and other high-impact categories • Monitor PMPM trends and utilization performance across specialties and all lines of business • Evaluate healthcare utilization to identify patterns, variation, and outliers and translate findings into actionable insights • Develop scalable analytical tools and dashboards to compare performance across markets, products, and populations • Assess the efficiency and effectiveness of clinical programs, interventions, and operational workflows • Analyze site-of-care optimization opportunities, network leakage, and utilization patterns across provider networks • Support intake, prioritization, and coordinated execution of ad-hoc and strategic analytics requests • Communicate findings clearly to technical and non-technical audiences, including executive-level stakeholders • Perform other duties as needed

🎯 Requirements

• Bachelor’s degree (or equivalent experience) in Public Health, Data Analytics, Health Informatics, Business, or a related field • 3+ years of experience with advanced SQL and Excel, including Power Query / Power Pivot, and Power BI in a healthcare analytics environment • Demonstrated ability to analyze and interpret large, complex healthcare datasets • Understanding of value-based care or risk-based arrangements • Strong analytical mindset with intellectual curiosity and a structured approach to problem-solving • High attention to detail, strong organizational skills, and ability to manage multiple priorities in a fast-paced environment • Exceptional written and verbal communication skills, with a bias toward clarity, conciseness, and actionable insights • Preferred: experience with data science tools or programming languages such as Python or R • Preferred: experience incorporating automation or AI-enabled tools into analytics workflows