Healthcare Economics Consultant Resume Samples
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Healthcare Economics Consultant Resume Samples
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MP
M Prosacco
Madisyn
Prosacco
254 Issac Islands
Phoenix
AZ
+1 (555) 111 8520
254 Issac Islands
Phoenix
AZ
Phone
p
+1 (555) 111 8520
Experience
Experience
Dallas, TX
Healthcare Economics Consultant
Dallas, TX
Abbott-Dicki
Dallas, TX
Healthcare Economics Consultant
- Maintenance existing production algorithms to maximize performance while working directly with the programmers to test and implement changes
- Work with Shared Services Teams to improve data assets
- Develop and prepare highly complex reports and provide and / or interpret information and data across divisions and departments
- Provides management with statistical findings and conclusions
- Provide management with statistical findings and conclusions
- Work in a small team atmosphere working on new corporate initiatives that return a financial value to the organization
- Provide ongoing, meaningful, communications to managers on project status, results and conclusions from analyses
San Francisco, CA
Healthcare Economics Consultant
San Francisco, CA
Franecki, Hahn and Brown
San Francisco, CA
Healthcare Economics Consultant
- Reviews work performed by others and provides recommendations for improvement
- Provide management weekly reports outlining work completed and issues encountered
- Perform population analytics to improve health outcomes and financial performance
- Collaboratively develop analytic models to evaluate financial impact of business strategies to manage pharmaceutical spend and trend
- Maintenance existing production algorithms to maximize performance while working directly with the data programmers to test and implement changes
- Provide data in support of operations, project work, and innovative/exploratory analyses
- Lead special projects with little to no manager supervision or assistance
present
Phoenix, AZ
Senior Healthcare Economics Consultant
Phoenix, AZ
Gislason-Donnelly
present
Phoenix, AZ
Senior Healthcare Economics Consultant
present
- Develop and improve quantitative data analytics and set performance targets
- Works with complex raw healthcare claims and clinical data, and recognizes data patterns and potential issues and makes recommendations
- Participate in analytical, experimental, investigative and other fact - finding work in support of concept development
- Develop, collect and analyze metrics and data to formulate fact-based decisions and proactively implement process improvements
- Works with relatively complex raw healthcare notifications and claims data, and recognizes data patterns and potential issues and makes recommendations
- Participate in analytical, experimental, investigative and other fact-finding work in support of concept development
- Provide executive level program updates and manage Optum team escalations
Education
Education
Bachelor’s Degree in Health Care
Bachelor’s Degree in Health Care
The University of Kansas
Bachelor’s Degree in Health Care
Skills
Skills
- Develop and improve quantitative data analytics and set performance targets
- Lead projects to completion by contributing to database creation, statistical modeling and financial reports
- Interpret and analyze clinical data from various sources and recommend best approaches
- Provide claims, premium, capitation and membership data in support of Underwriting, Actuarial and utilization analyses
- Create and update automated processes
- Analyze reporting tools to investigate sources of variations
- Produce and review reports
- Extract and analyze healthcare utilization data
- Participate in various committees that meet monthly by providing analyses that can help guide decisions and resource allocation
- Automate and maintain the monthly claims reserve schedules as well as provide any ad-hoc analysis into new and emerging claim completion patterns
10 Healthcare Economics Consultant resume templates
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1
Senior Healthcare Economics Consultant Resume Examples & Samples
- Interpret and analyze clinical, administrative, and financial data from various sources and recommend best approaches
- Analyze reporting to investigate sources of variations
- Supervise and mentor two staff analysts
- Advanced level proficiency with SQL
- Intermediate to advanced level of proficiency working with MS Excel including formulas, calculations, charts, graphs, etc
- Master's degree in Business, Economics, Healthcare Administration, Statistics, or other similar fields
- Lead analyst or supervisory experience
- 2+ years’ experience with T-SQL (Microsoft SQL)
- 2+ years’ experience working with a health plan or a risk-bearing physician organization in the capitated / delegated model
2
Senior Healthcare Economics Consultant Resume Examples & Samples
- Partner with Business Analyst and Data Analyst teams to plan, refine, and complete large development effort projects spanning multiple business teams
- Collect and prepare executive level updates for weekly and monthly project updates
- Focus on driving productivity and quality of algorithm outputs to allow identification staff to achieve and exceed monthly goals
- Develop, collect and analyze metrics and data to formulate fact-based decisions and proactively implement process improvements
- Use metrics, excellent time management skills and leadership skills to ensure business objectives and goals are met
- 1-3 years of in-depth knowledge of CMS and NAIC guidelines and programs
- Knowledge of fiscal planning exercises; planning for capital and maintenance funding programs
- Strong self-starter able to working with multiple leaders to coordinate strategic level projects
3
Healthcare Economics Consultant Resume Examples & Samples
- Support Clinical Documentation Quality Initiatives (CDQI) programs through development and presentation of reporting and analytics using a variety of data sources
- Serve as healthcare economics / analytics consultant for national and local level projects
- Research key business problems through quantitative analyses of healthcare data
- Provide data in support of operations, project work, and innovative/exploratory analyses
- 2+ years of Business Analysis and/or Financial Analysis experience
- 1+ years of experience with SQL/SAS, including the ability to code
- Previous experience working with and managing large amounts of data
- Undergraduate degree in related field
- Previous healthcare and / or health plan experience
- Experience with healthcare analysis / business intelligence tools: Optum One, SSIS, SSRS, MicroStrategy, etc
4
Healthcare Economics Consultant Resume Examples & Samples
- Develop scalable reporting processes and querying data sources to conduct ad hoc analyses
- Assume responsibility for data integrity among various internal groups and/or between internal and external sources
- Provide source system analysis
5
Healthcare Economics Consultant Resume Examples & Samples
- Create and update automated processes within client databases
- 1+ years of health care experience working with claims data and medical codes - Proficiency in performing data analytics - At least a beginner level proficiency with SQL, SAS and / or other statistical programs
- Experience / proficiency in SAS
6
Healthcare Economics Consultant Resume Examples & Samples
- Analyze business requirements for new reports to be developed
- Design, development and deployment of self service reports, scorecards and dashboards on healthcare data using the Microstrategy platform
- Analyze source systems and provide source to target mapping for the data warehouse
- Provide data modeling and design recommendations for data warehouse
- 4+ years of data analysis work experience
- 2 years of MicroStrategy report and dashboard development experience OR equivalent using other data visualization software such as Tableau
- MicroStrategy Architect / Project Design experience
- Data Modeling experience
7
Healthcare Economics Consultant Resume Examples & Samples
- Experience in analytics and working with large data sets, preferably working with healthcare data, either from educational study or professional experience
- At least an intermediate level proficiency with Access, SQL and/or other database programs
- At least an advanced proficiency level with MS Excel (Pivot tables, VLOOKUP, etc.)
- Objective, collaborative approach
- Exceptional written, verbal, analytical, organizational, problem solving and presentational skills
- Health care experience
8
Senior Healthcare Economics Consultant Resume Examples & Samples
- Interpret and analyze financial and clinical data from various sources and recommend best approaches
- Predict emerging customer needs and develop innovative solutions to meet them
- Research and investigate key business problems through quantitative analyses of utilization and healthcare cost data
- Translate highly complex concepts and conclusions in ways that can be understood by a variety of audiences
- Develop pioneering approaches to emerging industry trends
- Undergraduate degree
- 4+ years of healthcare and / or financial analysis experience
- Experience in data analysis using one or more of the following tools: SSAS, SSRS, MS-SQL Developer, SAS, Access
- Ability to work with and manage large amounts of data
9
Healthcare Economics Consultant Resume Examples & Samples
- Participate in analytical, experimental, investigative and other fact-finding work in support of concept development
- Influence tool strategy based on data driven research needs
- Establish strong matrixed relationships with internal and external stakeholders to define, align, and deliver payment integrity initiatives
- Influence senior leadership to adopt new ideas, approaches, and / or products
- Recommend changes to current product development procedures based on market research and new trends
- Industry thought leader and practice SME
- 1-2 years experience billing, coding and auditing claims
- Self-managed, self-starter with the ability to support multiple concurrent projects and meet delivery timelines
- Exceptional communication and negotiation skills
- Maintains working knowledge of Medicare rules and regulations and knowledge of procedure and diagnosis codes (CPT, ICD-9 / 10 coding, HCPCS and DRGs)
- 3+ years experience in the health care industry (Medicare, Medicaid, Commercial) with deep exposure to Payment Integrity
- 1+ years experience working in a matrix and highly adaptive environment handling tight deadlines
- Basic level proficiency with SQL
10
Senior Healthcare Economics Consultant Resume Examples & Samples
- Interpret and analyze clinical data from various sources and recommend best approaches
- Works closely with customers in determining analytic needs and presents outcomes of HCE analysis to customers
- Develops analytical plans including determining types of data needed, optimal study design and appropriate statistical analysis
- Works with complex raw healthcare claims and clinical data, and recognizes data patterns and potential issues and makes recommendations
- Performs statistical analyses to determine effectiveness of clinical programs
- Researches, identifies, and implements new approaches and methods to improve the quality and cost of care
- Leverages existing and ad-hoc reporting capabilities to identify trends in health plan performance and opportunities for medical expense reduction
- Collaborates within and outside the Medical Informatics department, UHC, and UHG to lead the development and continuous improvement of methods, processes, and technologies to enhance healthcare quality, affordability, outcomes, and member / provider experience
- Provides ongoing communications on project status, results and conclusions from analyses
- Generally work is self-directed, and serves as a resource to others
- Master’s degree or Ph.D. in a health care related field, economics, or social science
- SQL programming
- Working with relational databases
11
Healthcare Economics Consultant Resume Examples & Samples
- Interpret and analyze claims, capitation and membership data in support of operations and finance
- Lead projects to completion by contributing to database migrations and modification, statistical modeling and financial reports
- Create and update automated processes within databases
- 2+ years of business analysis
- At least a intermediate level proficiency with SQL
- 1+ years in crystal reporting
12
Healthcare Economics Consultant Resume Examples & Samples
- Ability to serve the team in a Lead position in the absence of Manager
- Provide claims, premium, capitation and membership data in support of underwriting, Actuarial and utilization analysis
- Complete business analysis on new analytic opportunities that may include proof of concept, functional testing, determination of yield, time to complete, and financial impact
- Explore potential trends identified by matrix business partners
- Generate functional business requirements used for automation of processes, analytic development, strategic reporting, and system navigation
- Strong research / investigation skills
- Possess excellent time management and prioritization skills in order to meet multiple deadlines; comfortable working in a high-paced / high production area
- Excellent critical thinking, written and verbal communication skills
- NAIC Guidelines knowledge
- At least a beginner level proficiency with SQL and/or other statistical programs
13
Healthcare Economics Consultant Resume Examples & Samples
- Reviews the work of others
- Serves as a leader / mentor
- Positions in this function research and investigate key business problems through quantitative analyses of utilization and healthcare costs data. Provides management with statistical findings and conclusions. Identifies potential areas for medical cost improvements and alternative pricing strategies. Provides data in support of actuarial, financial and utilization analyses
- Intermediate level with Sybase
- At least an intermediate with SQL, ORACLE or other statistical programs
- Experience with Oracle & Sybase
- Experience with Crystal Business Objects reporting
- Experience with Microstrategy
14
Senior Healthcare Economics Consultant Resume Examples & Samples
- 4+ years of experience in health care analytics and working with large data sets
- 4+ years SAS programming experience (PC or UNIX)
- Performs as a technical peer expert to other junior level SAS programmers
- Ability to work with unstructured data
- Must be a self-starter, detail-oriented, and strong analytic skill sets
- Ability to work with minimal guidance
- Strong problem-solving and analytical skills
- Excellent SAS technical / advanced level programmer
- Excellent critical thinker
15
Healthcare Economics Consultant Resume Examples & Samples
- Maintenance existing production algorithms to maximize performance while working directly with the programmers to test and implement changes
- Monthly analysis of algorithm performance; forecasted vs. actuals
- Lead special projects with little to no manager supervision or assistance
- Proficient with excel to include pivot tables, foundational formulas, charts, etc
- Analytical mindset with critical thinking skills
- Outgoing and able to effectively engage with internal clients (employees and leaders within other areas of the business)
- Comfortable working in a high - paced production area
16
Healthcare Economics Consultant Resume Examples & Samples
- 3+ years demonstrating strong financial analysis skills and critical thinking skills
- 3+ years working with large data sets
- 2+ years demonstrable project experience
- 5+ years claims experience and / or coding knowledge (Emphasis is on Hospital / UB92 claims)
- 2+ years working with Medicare, Medicaid and / or Commercial health plans and payment methodology
- Intermediate to Expert level of skill with MS Excel
17
Senior Healthcare Economics Consultant Resume Examples & Samples
- Will investigate key business problems through quantitative analyses and will interpret and analyze clinical data from various sources and recommend opportunities for improvement
- Tableau experience
- 3+ years of experience in health care analytics and working with large data sets or claims experience
- Intermediate level proficiency with SQL, SAS and / or other statistical programs
- Certification of medical coding or 5+ of coding experience
18
Senior Healthcare Economics Consultant Resume Examples & Samples
- Translate business requirements into technical specifications
- Define, develop and document business requirements to ensure client needs are captured and delivered timely
- Participate in data and code quality reviews for both individual and team analytic files, conducting quality assurance testing and removing defects
- Create written and oral communication materials that effectively summarize findings, support fact-based recommendations and provides appropriate detail to substantiate conclusions
- Maintain documentation, project methodologies and other artifacts that will be utilized in communication to senior leaders
- Work cross functionally with multiple teams including but not limited to Data Management, Actuarial and Finance teams
- Bachelor's degree or equivalent experience, preferably technical discipline
- 4+ years of expertise SQL, SAS and / or other coding languages
- Demonstrated experience creating both business and technical specifications
- Must have excellent verbal and written communication skills with the ability to translate complex technical specifications to non-technical audiences
- Demonstrated experience in the development, implementation and execution of building key analytic files for use in financial analysis
- Strong conceptual and analytical skills
- Comfortable working with less structured, more complex issues that require development of innovative solutions
- Adaptable to a rapidly changing environment; ability to quickly shift focus as priorities change
- Advanced level of proficiency working with MS Excel
- Proficiency working with claims, enrollment and provider healthcare data sources
- Database navigation capability
- Finance / affordability background
19
Senior Healthcare Economics Consultant Resume Examples & Samples
- Extract and compile cost and utilization data
- Review claims, premium, capitation and membership data in support of ACO
- Collaborate with cross-functional teams
- Analyze benchmarking data, reports, processes, and measurements
- Develop / document business, analysis and reporting requirements
- Independently interpret data, facts and / or trends
- Ad Hoc analysis
- Experience directing cross-functional teams
- Expert level proficiency with SQL, SAS and / or other statistical programs
- Substantial analysis & problem solving experience
- Good verbal and written communication skills
- Independent contributor with experience in management reporting
20
Healthcare Economics Consultant Resume Examples & Samples
- Research potential overpayment scenarios through the use of client policies and provider contracts to identify overpaid claims used to build recurring algorithms
- 1+ year of Medicare experience
- Comfortable working in a high-paced production area
- AHIMA, CCSP, or AAPC, CPC, certification
21
Healthcare Economics Consultant Resume Examples & Samples
- NAIC Guidelines knowledge or years of Coordination of Benefits auditing
- Proficiency working with MS Excel including formulas, calculations, charts, graphs, etc
- Proficiency in performing data analytics (SAS or SQL)
22
Healthcare Economics Consultant Resume Examples & Samples
- Perform data mining and analysis that impacts foundational pricing and risk assumptions
- Provide accurate premium rate development
- Perform financial analysis to improve health plan competitiveness
- Support reserve development
- Build financial models
- Extract and compile group specific utilization data to support customer reporting requirements
- Analyze and interpret quantitative data
- Create and review monthly / quarterly and ad hoc exhibits based on detailed data sets
- Collaborate and communicate results and technical concepts
- Assist in the preparation of annual revenue and claim forecasts to determine group-specific reserves
- Develop data reporting capabilities and proactively identify solutions to problems
- 2+ years of experience working in a corporate environment including experience collecting, analyzing and summarizing qualitative / quantitative data
- Expertise working with formulas, calculations, charts, graphs in MS Excel
- Experience working in finance or the health care industry
- 1 year of experience building Actuarial models in SQL (Structured Query Language), SAS (Statistical Analysis System) and / or VBA (Visual Basic for Applications)
23
Senior Healthcare Economics Consultant Resume Examples & Samples
- Identify savings initiatives that drive specific and measurable results for assigned clients, providing timely and meaningful client updates
- Participate in analytical, experimental, investigative and other fact - finding work in support of concept development
- Establish strong matrixed relationships with internal and external stakeholders to define, align, and deliver payment integrity initiatives in support of assigned clients
- 3 - 5 years experience billing, coding, and auditing claims
- Self - managed, self - starter with the ability to support multiple concurrent projects and meet tight delivery timelines
- Strong project management approach with excellent critical thinking and problem solving skills
- Exceptional presentation, communication and negotiation skills
- Strong computer skills: Access, Excel, Visio, PowerPoint
- Maintains working knowledge of CMS rules and regulations and knowledge of procedure and diagnosis codes (CPT, ICD - 9 / 10 coding, HCPCS and DRGs)
- 5+ years experience in the health care industry (Medicare, Medicaid, Commercial) with deep exposure to Payment Integrity
- 2+ years experience working in a matrix and highly adaptive environment handling tight deadlines
- Coding certification through AAPC or AHIMA
24
Healthcare Economics Consultant Resume Examples & Samples
- Extract and analyze healthcare utilization data
- Participate in various committees that meet monthly by providing analyses that can help guide decisions and resource allocation
- Provide analytical support to different departments through ad-hoc reporting and analysis as needed
- Automate and maintain the monthly claims reserve schedules as well as provide any ad-hoc analysis into new and emerging claim completion patterns
- Create automated processes for standard reports to alleviate manual work
- Bachelor’s degree or a combination of education and healthcare work experience
- 3 years of experience in healthcare analytics working with large data sets
- Intermediate level of proficiency with SQL
- Intermediate to advanced level of proficiency with Excel – graphs, formulas, charts, macros, etc
- Intermediate level of proficiency with SAS a plus
- Advanced level of proficiency with SQL – writing complex sub-queries, table design, creating stored procedures, etc
- Strong verbal and written communication skills – ability to present report findings to mid-level and executive leadership
25
Healthcare Economics Consultant Resume Examples & Samples
- Review of provider contract system set up to identify errors related to medical claim overpayment scenarios
- Load provider contract reimbursement rates into our contracting application
- Analyze claims paid data to identify possible predictive payment patterns
- Collaborate with internal teams to research and solve issues around claims and internal tool pricing
- Identify and implement process improvements within and across teams
- At least 1 year of experience working with medical claims; submission, processing, adjudication, or provider contracting
- Proficient in MS Excel including formulas, formulas, charts, graphs, pivot tables, etc
- Previous experience around identifying data anomalies through the use of large data sets
- Ability to breakdown a complex problems into individual root causes
- Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand
- Experience with both facility and physician payment methodologies
- Knowledge in claims platforms such as Cosmos, UNET, NDB, CSP
- Knowledge in Commercial, Medicare and/or Medicaid reimbursement methodologies and system set-up
- Previous team lead or manager experience a plus
26
Healthcare Economics Consultant Resume Examples & Samples
- Create and update automated processes within client databases Analyze reporting tools utilized by the internal customer groups
- Use notifications, claims or / and membership data in support of business operations, and utilization, network and process / program analyses
- Leverages existing and ad - hoc reporting capabilities to identify trends in health plan performance and opportunities for medical expense reduction
- Provides consultative advice and interprets and summarizes analytical findings
- Generally work is self - directed, and serves as a resource to others
- 2+ years of work experience
- Beginner level of proficiency with MS Access
- 2+years’ experience analyzing very large datasets
- 2+ years of SAS programming on a UNIX platform or Enterprise Guide(EG)
- Basic level of Visual Basic
27
Healthcare Economics Consultant Resume Examples & Samples
- Intermediate level of proficiency in one of the following: SQL, SAS, MS Access or similar data analysis software
- Degree in Statistics, Economics, Epidemiology or related field
- Experience / proficiency in SAS and / or other statistical program
28
Healthcare Economics Consultant Resume Examples & Samples
- Provide on-demand analysis and reporting on key business issues in support of company Clinical, Financial, Operational, and Quality performance measurement and operations
- Lead projects to completion by contributing to reporting requirement gathering, development, and documentation
- Intermediate level proficiency with SQL
- Experience with querying Oracle data warehouse environments
- Experience in development of Crystal reports or other automated reporting solutions
29
Healthcare Economics Consultant Resume Examples & Samples
- Create experience tracking reports at various levels of detail, including rate-cell / regional reporting consistent with revenue reimbursement for all FL C&S products
- Lead presentations to health plan leadership
- Manage and prioritize health plan project requests
- Partner with regional and local UHN leaders to develop and drive Network strategies, including supporting VBC target identification, contract development support, and ad hoc reporting / evaluation support for non-standard deals
- Work with Shared Services Teams to improve data assets
- At least a beginner level of proficiency with Access
30
Senior Healthcare Economics Consultant Resume Examples & Samples
- Use notifications, claims or/and membership data in support of business operations, and utilization, network and process/program analyses
- 3 years of data analytics
- 3+ years of health care experience working with notifications or claims data
- Demonstrated proficiency in SAS programming
- Proficient with MS Excel, including formulas, calculations, charts, graphs, etc
- Experience analyzing very large datasets
- SAS programming on a UNIX platform or Enterprise Guide(EG)
31
Senior Healthcare Economics Consultant Resume Examples & Samples
- Prototype new and complex reporting for hand-off to IT using knowledge of healthcare administrative claims data and advanced T-SQL coding skills
- Design, automate, and maintain Monarch HealthCare’s evolving key performance indicator (KPI) reporting
- Work with Monarch’s departmental leadership to set meaningful data-driven measurements and goals as represented in the KPI
- Design, automate and maintain claim reserve schedules and also provide insight to the actuaries for new and emerging claim completion patterns
- Support Monarch’s provider overpayment unit with customized tools to capture performance data, create efficiency with automation, and management insight with reporting
- Provide ad hoc analysis and reporting for leadership leveraging Monarch’s robust data warehouses
- 5+ years relevant work experience in a healthcare or managed care environment working with large data sets using SQL (preferably Microsoft’s T-SQL)
- Advanced proficiency in SQL and Microsoft Excel
- Knowledge of Medicare provider payment systems (chiefly hospital and physician systems)
- Experience analyzing performance of the Medicare Pioneer ACO financial model
- Experience in supporting provider and health plan contracting from a finance point of view
- Experience using population health analytics tools including the use of predictive risk analytics
32
Healthcare Economics Consultant Resume Examples & Samples
- Collaboratively develop analytic models to evaluate financial impact of business strategies to manage pharmaceutical spend and trend
- Interpret and analyze pharmaceutical claims and cost trends to identify management opportunities and measure the impact of strategy implementation
- 3+ years of experience in data analytics and / or financial modeling
- Advanced or higher level of proficiency with MS Excel (including formulas, calculations, charts, graphs, etc.)
- Healthcare or PBM experience
- SQL, SAS, VBA, or Access programming experience
33
Healthcare Economics Consultant Resume Examples & Samples
- Design and develop data queries through SAS and other tools to create models for analyzing business opportunities and interpreting key drivers of health care trends (i.e. medical cost, utilization, etc.)
- Provide claims, premium, capitation and membership data in support of Underwriting, Actuarial, Product and utilization analyses
- Identify and implement appropriate analytic approaches/methodologies and perform quality assurance
- Provide ongoing, meaningful, communications to managers on project status, results and conclusions from analyses
- Bachelor's degree, preferably in Finance, Math, Statistics, Actuarial Science, Economics or a related degree
- At least an intermediate proficiency with MS Excel for data analytics
- Experience with SAS, SQL and/or other statistical programs
- Knowledge of healthcare industry
- Experience working with large data sets
- Comfortable in interactions with various levels of management
- Self-motivated to prioritize work on multiple complex assignments
- Ability to work successfully in an ever-changing, priority driven environment
- Ability to learn quickly and produce high-quality work
34
Senior Healthcare Economics Consultant Resume Examples & Samples
- Responsible for researching and investigating key business problems through quantitative analyses of utilization and healthcare costs data
- Potentially manage and lead a team of analysts- own and deliver sophisticated analytic deliverables
- Client facing, regularly meet and work with client to drive actionable reporting
- Well-developed understanding of epidemiologic, pharmacoeconomic, and health services research design and methods, including the various methods of economic evaluation
- 4+ Experience with SAS or SQL
- 4+ years of experience with healthcare data
- 4+ years of experience with data reporting and analysis
- Master’s degree in epidemiology, biostatistics, pharmacoeconomics, health services research, economics, health economics, public health or a related quantitative discipline
- PhD degree in epidemiology, biostatistics, pharmacoeconomics, health services research, economics, health economics, public health or a related quantitative discipline
- Intermediate to Advanced VBA skills
- Advanced reporting skills using software like Tableau, Cognos, Futrix
35
Healthcare Economics Consultant Resume Examples & Samples
- Interpret and analyze claims, premium, capitation and membership data in support of utilization analyses
- Perform population analytics to improve health outcomes and financial performance
- Intermediate level of proficiency in SAS or SQL
- Degree in Statistics, Economics, Mathematics, Public Health, Epidemiology or related field
36
Healthcare Economics Consultant Resume Examples & Samples
- Perform as a technical business analyst on Medicare projects and reports
- Beginner level proficiency with SQL, SAS and / or other statistical programs
- Project Management or Business Analyst experience
37
Healthcare Economics Consultant Resume Examples & Samples
- Interpret and analyze claims, premium, and capitation and membership data in support of Underwriting, Actuarial and utilization analyses
- 5+ years of analysis and reporting experience in a health care environment
- Beginner level proficiency with SAS and / or other statistical programs
38
Senior Healthcare Economics Consultant Resume Examples & Samples
- Communicate analytic results to the business audience using static and dynamic graphic and tabular displays of data, written reports, and presentations
- 3+ years of experience in analytics working with large data sets (health care experience desired)
- At least an intermediate level proficiency with SQL (inner and outer joins, sub-selects, etc.)
- Master's degree in the fields of Epidemiology, Public Health, Statistics, Biostatistics, Health Economics, or related field
- Experience with Medicare Advantage risk adjustment programs and/or Stars / HEDIS quality analysis
- Strong understanding of health care industry products / services and operations
- Experience conducting data analysis in healthcare settings
39
Healthcare Economics Consultant Resume Examples & Samples
- Proficiency with performing mid-level-to-advanced data analytics such as cost avoidance modeling, financial modeling, risk adjustment and/or statistical analysis
- At least an intermediate level proficiency with basic statistical methods
- At least an intermediate proficiency in SQL (advanced preferred), SAS and/or other statistical programs
- At least an intermediate level of proficiency working with MS Excel including formulas, calculations, charts, graphs, etc. (advanced preferred)
- Master’s degree in a health or quantitative field
- Experience using Tableau or Visual Insight
40
Healthcare Economics Consultant Resume Examples & Samples
- Works with less structured data, and recognizes data patterns and potential issues and makes recommendations
- Proactively discovers potential areas for medical cost improvement and management / healthcare initiative strategies
- Performs data extraction, aggregation, and quality checking from multiple sources and tables in support of trend identification, root cause analysis, affordability initiative development, and validation/measurement of medical expense reduction initiatives
- Researches, identifies, and implements new approaches and methods to facilitate medical cost management
- Bachelor’s degree or equivalent work experience
- 3+ years of work experience in data analytics using SAS
- 2+ years UNIX / AIX (6.1)
- Experience working with relational databases and large data sets
- Strong SAS programming skills including Data step, SAS macros, Proc SQL, and SAS / DDE
- Proficient with MS Excel
- M.S. degree
- Excellent SAS technical/advanced level programmer
41
Healthcare Economics Consultant Resume Examples & Samples
- 3 or more years of work experience in data mining analysis
- 3 or more years of health care experience working with claims data and medical codes
- Proficiency with SQL and SAS
42
Senior Healthcare Economics Consultant Resume Examples & Samples
- Identify savings opportunities that drive initiatives resulting in specific and measurable cost reduction for clients
- Participate in analytical, investigative and research work in support of concept development
- Develop strategic and tactical plans for execution on cost-savings initiatives
- Provide timely, concise and meaningful client updates
- Establish strong relationships with internal and external stakeholders to define, align, and deliver payment integrity initiatives in support of assigned clients
- 3 - 5 years’ experience billing, coding, and auditing claims
- Policy, benefits, and reimbursement knowledge for home health, hospice, and / or nursing home services
- Familiarity with Medicaid waiver programs
- 5+ years’ experience in the health care industry (Medicare, Medicaid, Commercial) with deep exposure to Payment Integrity
43
Senior Healthcare Economics Consultant Resume Examples & Samples
- Oversee the ideation function that identifies medical cost savings opportunities and manage that portfolio of work to maximize client value delivery
- Participate in analytical, investigative, and other fact-finding work in support of new concept development
- Establish strong client and matrix partner relationships to define, align, and deliver payment integrity solutions in support of assigned clients
- Provide executive level program updates and manage Optum team escalations
- Influence client leadership to adopt new ideas, approaches, and/or products
- Operate as an industry thought leader and Payment Integrity SME
- 2-5 years’ experience in Payment Integrity or with billing, coding, and auditing claims
- Maintains working knowledge of CMS rules and regulations and knowledge of procedure and diagnosis codes (CPT, ICD-9 /10 coding, HCPCS and DRGs)
- 2+ years’ experience working in a matrix and highly adaptive environment handling tight deadlines
- Self-managed, self-starter with the ability to support multiple concurrent projects and meet tight delivery timelines
44
Senior Healthcare Economics Consultant Resume Examples & Samples
- Identify savings initiatives that drive specific and measurable results, providing timely and meaningful client updates
- Influence senior leadership to adopt new ideas, approaches, and/or products
- 3-5 years’ experience billing, coding, and auditing claims
- Maintains working knowledge of CMS rules and regulations and knowledge of procedure and diagnosis codes (CPT, ICD-9/10 coding, HCPCS and DRGs)
45
Healthcare Economics Consultant Resume Examples & Samples
- At least an intermediate level of proficiency in performing data analytics
- At least an intermediate level of proficiency with MS Access
- Previous leadership experience (SME, team lead, supervisor or manager)
46
Healthcare Economics Consultant Resume Examples & Samples
- Produce and review reports specific to risk adjustments for various markets
- 2+ years of SAS experience (Base SAS, Macros, Proc SQL, SAS EG)
- Experience with UNIX or LINUX systems
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Senior Healthcare Economics Consultant Resume Examples & Samples
- Would be dedicated to MyConnections, an excellent Tableau person, but needs to have a breadth of other skills to support end - to - end prototypes. Requires ability to acquire data and load temporary tables to support the Tableau reporting. The ability to join that data with existing data we have in SMART (oracle skills). Data visualization is important as is someone that can speak Health Care
- 6+ years of data analysis work experience
- 3 years of reports, scorecard, dashboards development experience data visualization software such as Tableau, Microstrategy, Wave Analytics or similar
- 3+ years of experience working in a Data Warehouse environment, including experience in acquiring and merging data sets from multiple sources as necessary for building analytics prototypes
- Bachelor’s Degree, CIS or related field
- End User Training experience for reporting platforms
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Healthcare Economics Consultant Resume Examples & Samples
- Performs complex conceptual analyses
- Forecasts and plans resource requirements
- Authorizes deviations from standards
- Interpret and analyze claims, clinical and membership data in support of healthcare forecasting and utilization analyses
- Lead projects to completion by contributing to reporting solutions, statistical modeling and financial analytics
- 3+ years working in a team environment
- Crystal reporting
- MicroStrategy
- Oracle databases
