Healthcare Economics Job Description
Healthcare economics
provides claims, provider, and membership data in support of monthly production, reporting, and data extraction for the clients.
Healthcare Economics Duties & Responsibilities
To write an effective healthcare economics job description, begin by listing detailed duties, responsibilities and expectations. We have included healthcare economics job description templates that you can modify and use.
Sample responsibilities for this position include:
Collects and manipulates quantitative data for analysis using SQL, SAS, R, or Python
Utilizes data visualization tools such as Tableau to make insights understandable to internal and external customers
Identify, collect, and manipulate from a wide variety of financial and clinical internal data bases (e.g., Star, TSI, PCON, Epic) and external sources (e.g., Medicare/Medicaid website)
Collaborates within and across functions to prioritize HEMA-related RWD projects across the business
Identifies trends, patterns and relationships in the data to answer questions or research problems posed by organization
Collaborates with members of the department, SME’s, and internal customers in ongoing decisions regarding study design, data collection, data analysis and methodology
Serves as partner to epidemiologists and statisticians to ensure excellence related to statistical modeling and algorithm design for solving problems
Able to engage and lead with senior customers at the C-Suite and VP level at leading institutions on their data needs and identify solutions to analyze and interpret their data
Oversee the provision of Data Warehousing, Healthcare Economics, Business Analysis and Data Integration capability to the Nevada Market, Harken Health and the Care Delivery
Conduct a deep dive analysis of current Health Economic Landscape for our core segments, Intermittent Catheters, MEC, Leg Bags, across our core geographies
Healthcare Economics Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Healthcare Economics
List any licenses or certifications required by the position: AHIMA, CCSP, AAPC, CPC, HTA
Education for Healthcare Economics
Typically a job would require a certain level of education.
Employers hiring for the healthcare economics job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Master's Degree in Economics, Statistics, Finance, Mathematics, Health, Public Health, Biostatistics, Epidemiology, Health Services, Math
Skills for Healthcare Economics
Desired skills for healthcare economics include:
Healthcare administrative data
Tableau
Claims processing
Medicare
Healthcare industry
Statistical methods used in the evaluation of healthcare claims data
CMS regulations and specifications in regards to Medicare Advantage risk adjustment
SQL
Managed care contracts and principles and concepts of statistical analysis
Data and the systems that generate it
Desired experience for healthcare economics includes:
Experience leading health economic modeling projects from concept through publication is required
Experience in the medical device industry strongly preferred
Experienced in developing statistical and predictive models and utilizing models to answer questions and solve problems is required
Knowledge of US medical claims data and at least one year prior work experience using US hospital data and other longitudinal data sets is an asset
Strong communication skills and experience presenting data to senior professionals and customers such as hospital c-suite executives is required
Working knowledge of propensity models, classification models (decision trees), cluster models, and unsupervised learning techniques is required
Healthcare Economics Examples
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Healthcare Economics Job Description
Job Description Example
Our company is growing rapidly and is looking to fill the role of healthcare economics. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for healthcare economics
- Lead strategic pricing analysts and managers, who support the negotiation and implementation of appropriate reimbursement rates and associated language, between physicians/hospitals and payers/networks in all managed care payer contracting initiatives
- Develop and lead team, enhancing and ensuring their opportunity to successfully manage revenue and reimbursement responsibilities
- Assure satisfactory contract financial performance
- Provide training and oversight of the modeling of proposed/existing payer contracts negotiated by payer strategy and operations, including expected and actual revenues/volumes, past performance, proposed contract language and regulatory changes
- Analyze terms of new and existing risk and non-risk contracts and/or amendments/modifications using approved model contract language and following established negotiation procedures
- Act as a liaison between CHI and payer to update information and communicate changes
- Oversee and prepare complex service line reimbursement analyses and financial performance analyses
- Maintain knowledge of operations sufficient to identify causative factors, deviations, allowances that may affect reporting findings
- Prepare routine reports and ad-hoc analyses as directed, with ability to accurately reflect actual performance trends
- Develop, implement and monitor corporate policy & procedure to ensure appropriate and periodic reviews and maintenance of CHI's provider charge master pricing levels
Qualifications for healthcare economics
- Must be able to communicate ideas and analysis results effectively both verbally and in writing to both a technical and non-technical audience
- Must demonstrate a superior ability to recognize and define problems, understand business and system processes, collect data, establish facts, and draw valid conclusions
- Working ease with Microsoft Office suite including tools such as Excel, PowerPoint, Word and Visio
- Project Management experience required (Agile Methodology experience preferred, ITIL, SCRUM)
- A university degree in the health sciences
- Prior experience with medical devices and/or pharmaceutical industry desired
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Healthcare Economics Job Description
Job Description Example
Our innovative and growing company is searching for experienced candidates for the position of healthcare economics. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for healthcare economics
- Works with revenue and reimbursement team to determine key performance indicators and monitors progress toward success in achieving goals throughout the year
- Lead and provide guidance to revenue and reimbursement budgets and prepares annual updates
- Mentor and develop your elite team of analysts and actuaries
- Works in collaboration with regional commercial leadership in developing regional product-specific reimbursement strategies based on the requirements of technology assessment organizations and payers
- Communicate evidence requirements and reimbursement landscape, across the regions, to the Commercial teams and colleagues
- Develops sustainable strategic relationships with professional societies, medical associations, advocacy groups, thought leaders and trade groups to provide leadership and focus in areas of mutual interest such as physician reimbursement, treatment guidelines, coverage and payment for products/therapies
- Management - Establish and support a work environment of continuous improvement that supports the Quality Policy, Quality System and the appropriate regulations for the area they support
- Lead and direct the Healthcare Financial Economics team
- Understands the business needs of the organization - its clients, providers, and delivery systems
- Responsible for personnel issues including recruitment, selection, hiring, training, reviewing, promoting, and administering discipline
Qualifications for healthcare economics
- A minimum of a Bachelor’s degree AND advanced degree required in a HEMA related discipline preferred
- Experience with predictive modeling and/or statistical analysis in a statistical tool such as SAS, R, or Python is required
- Must possess analytical skills to evaluate, understand and interpret data from both internal and customer perspective
- Demonstrated use of business and financial measures, economic modeling, and the impact on reimbursement issue resolution
- Seven (7) years minimum related experience in healthcare sales required
- Advanced proficiency working with MS Excel including advanced formulas, pivot tables, macros, lists, statistical functions
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Healthcare Economics Job Description
Job Description Example
Our growing company is looking to fill the role of healthcare economics. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for healthcare economics
- Coordinate domestic & international travel, hotel accommodations, meeting schedules and expense reporting for Vice Presidents and select direct reports
- Answer/screen calls for Vice Presidents
- Prepare, maintain, generate and process essential documents and records (e.g., expense reports, check requests, and CPAs)
- Must possess a detailed understanding of existing clinical and economic evidence to support product positioning
- Develop, lead and implement clinical development strategy
- Responsible for planning and execution of all CRO contracted activities including consulting, monitoring, statistical analysis
- Communication in the Organization of all clinical related activities
- Posting and maintenance of all relevant clinical activities with the NIH on www.clinicaltrials.gov or other applications as required
- Creation, maintenance and management of all department budget related activities in a cost-effective and timely manner
- Interfacing with all principal investigators, DSMB members, sub-investigators, study coordinators and other relevant study participants in order to effectively execute clinical activities
Qualifications for healthcare economics
- It is anticipated that the candidate will have already had experience of consulting in health industries
- Master's degree in Health Administration, Management Decision Sciences, Statistics, Economics, or other business-related field a plus
- Experience with Excel and statistical programming packages such as Visual Basic, SAS, STATA, R, Matlab or Mathematica
- Actuarial experience desirable (ASA or FSA and MAAA)
- Advanced quantitative skills are required
- 5+ years of leadership experience (2 years of which may be substitutable by a graduate degree)
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Healthcare Economics Job Description
Job Description Example
Our company is hiring for a healthcare economics. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for healthcare economics
- Oversee the implementation of economic models, value messaging, publication, and development of customer-facing economic tools
- Build and maintain advanced understanding of US and OUS healthcare market mechanisms, payer and provider trends, health policy, medical technology, and reimbursement trends in order to inform strategic decision making with respect to healthcare economics and clinical research needs
- Direct the work of vendors and outside researchers to accomplish the goals of the organization with respect to data sources, research studies, and development of economic models and tools
- Work with clinical teams to ensure that appropriate health economic information is collected in the course of clinical research studies
- Implement tactical planning activities required to achieve health economics and reimbursement strategic objectives (e.g., preparation of economic and reimbursement dossiers for payer negotiations, new code applications, customer billing guides, and economic models)
- Support Corporate Account (IDN's/GPO's) initiatives and strategies
- Assist in development and preparation of reports
- Oversee/direct statistical and empirical analysis using large datasets
- Assist in development of analytics and projects including preparation of RFP responses
- Coordinate projects with other practices at FTI
Qualifications for healthcare economics
- Support the European Country Sales teams (i.e., Germany, France, UK, Italy, ) through health and hospital economic insights
- Develop economic solutions to demonstrate hospital stakeholders HTA groups the value of the da Vinci® Surgery programs
- Work collaboratively with Global Market Access & HEOR teams, on the evidence development, education and direct customer dissemination of the impact of the da Vinci® Surgery programs to external decision makers
- University degree with 12+ years extensive experiences and working knowledge of European healthcare systems and hospital providers, surgeons, technology assessment agencies, reimbursement system and trends impacting technology and adoption
- Hands On Data Science Professional with prove Leadership and Analytics experience
- A minimum of six years administrative assistant experience is required, preferably in a role supporting a Vice President
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Healthcare Economics Job Description
Job Description Example
Our company is growing rapidly and is looking for a healthcare economics. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for healthcare economics
- The ideal applicant will work in the Franklin, TN, or Wauwatosa, WI offices
- Provide necessary information for estimation and valuation of health claims liabilities, including detailed analysis for auditor review, within required timelines of the monthly close process
- Direct and manage external third-party vendors providing HCE-related services
- Support analytics, bill auditing, warehousing of clinical and financial data, dashboard reporting, risk accuracy, and data/encounter submissions to external parties
- Monitor monthly claims workflow/production, including investigation and resolution of adverse changes in production statistics and their impact on medical accrual estimates
- Direct data integration, data analytics, and predictive modeling processes to meet business requirements
- Identify trends & key drivers in revenue and medical expenses
- Ownership of the Business Initiative process to analyze and optimize medical spend and ensure success for the health plan in establishing and achieving revenue, medical and gross margin targets on a routine basis according to forecasts
- Participation in the premium rate-setting process
- Support the annual HEDIS cycle and the Provider Incentive Programs
Qualifications for healthcare economics
- Extensive broad based experiences and working knowledge of US healthcare systems and hospital providers, payers, surgeons, technology assessment agencies, reimbursement system and trends impacting technology and adoption
- Extensive experience and comfort in presenting and defending evidence with key clinical and economic decision makers in meetings
- Extensive experience in health economics, market and patient access, and interaction with hospital stakeholders and decision makers
- Provide perspective and operate analytical models, global and country specific value dossiers and libraries to perform real-time analyses and illustrate opportunities and impact
- Assist in developing commercially accepted economic material “leave” behind
- Perform and oversee country broad-based economic assessment and highlight meaningful regional influences and trends with little direction