Medical Economics Analyst

Job not on LinkedIn

🔥 12 minutes ago

🦌 Connecticut, New Jersey, +2 more states – Remote

🦌 Connecticut – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote 🔔 Pennsylvania – Remote

💵 $87.3k - $119.1k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

👻 Ghost score 16%

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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Horizon Connect @ Wall BCBSNJ

WebsiteLinkedInAll Job Openings

2 - 10 employees

⚕️ Healthcare Insurance

🏥 Healthcare

Healthcare Insurance • Healthcare

Horizon Connect @ Wall BCBSNJ is a LinkedIn presence or local program/office associated with Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ). Based on the name and context, it appears to be connected to Horizon BCBSNJ’s health insurance operations and local outreach or member/provider engagement in the Wall, NJ area. Publicly available information provided is limited and mostly LinkedIn site chrome rather than a company profile, so this description is conservative and based on the affiliation indicated by the name.

📋 Description

• Provide analysis to inform strategic network and medical cost management strategies • Develop and monitor metrics and reports related to medical cost performance • Understand attributed membership and shared savings calculations and support Value Based Program integrity through objective review and validation • Develop and lead monthly Healthcare Management reporting covering variance analysis, revenue, medical cost, product mix, and market segments • Coordinate and consolidate the Healthcare Management Monthly Operating Review (MOR) • Gather multidisciplinary analytics to evaluate medical cost activities and consult with business leaders on observations and recommendations • Support Value Based Program analytics through data mining, data extraction, report and presentation design, financial modeling, identifying medical cost trend drivers, and consolidating medical action plans • Implement analytic tools and techniques to identify cost drivers and improve medical cost performance • Evaluate strategic initiatives and new business opportunities, including financial program scenarios for Value Based Program partners • Participate in developing the future state of Value Based Programs • Work with multidisciplinary teams to quantify return on investment and track medical cost reduction initiatives • Coordinate with finance and actuarial teams to connect medical cost activities to the enterprise financial process

🎯 Requirements

• High School Diploma/GED required • Bachelor degree in accounting or finance preferred or relevant experience in lieu of degree • Minimum of 3-5 years of experience in health care/managed care with direct responsibility within a Financial Planning & Analysis (FP&A) and/or Medical Cost Management & Analysis discipline • Progressive understanding of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, product pricing, network and provider contracting, and utilization management • Experience working closely with Analytics, Actuaries and/or FP&A on medical cost analysis, market segment premium development, monthly financial reporting and variance analysis, annual business plan/budget development and management presentations • Solid understanding of P&L management principles, actual versus budget variance analysis, and budgeting and planning principles • Knowledge of medical cost and utilization trends and year-over-year comparisons • Knowledge of Commercial and Medicare market sectors and products • Knowledge of healthcare/managed care industry operations, products, and financial statement metrics • Proven quantitative and financial analysis skills • Clear and concise verbal and written communication skills • Analytical thinking and accurate reporting abilities • Problem research and resolution skills through interaction with company-wide personnel • Process mapping capabilities • Ability to work independently with minimal direct supervision and exercise sound business judgment • Direct knowledge or ability to quickly learn Horizon's Accounting and FP&A platforms, including Lawson General Ledger and Hyperion Planning • Advanced knowledge of Excel • Experience with Word and PowerPoint • Technical skills with database concepts, data analysis development, data warehousing, and data extraction tools such as SQL • Employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware

🏖️ Benefits

• Comprehensive health benefits (Medical/Dental/Vision) • Retirement Plans • Generous PTO • Incentive Plans • Wellness Programs • Paid Volunteer Time Off • Tuition Reimbursement