Healthcare Economics Consultant Job Description
Healthcare economics consultant
provides leadership with quantitative analyses of healthcare cost and utilization data, identifying and implementing the appropriate analytic approaches and methodologies.
Healthcare Economics Consultant Duties & Responsibilities
To write an effective healthcare economics consultant job description, begin by listing detailed duties, responsibilities and expectations. We have included healthcare economics consultant job description templates that you can modify and use.
Sample responsibilities for this position include:
Provides Medicare Enterprise financial support in the analysis of medical expenses, medical expense trend, membership, revenue, medical loss ratio and drill downs reports
Provides Medicare Business Units and leaders with analysis of revenue and medical costs on a restated basis assisting Regional finance leaders with medical trend analysis and risks (trend anomalies, outliers, behaviors)
5+ years of analysis and reporting experience in a health care environment strongly preferred
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
Would be dedicated to MyConnections, an excellent Tableau person, but needs to have a breadth of other skills to support end - to - end prototypes
Claims cost and data analysis
Provides presentations of results
Design, develop and prepare reports and provide and/or interpret information and data across divisions/department
Provide claims, premium, capitation and membership data in support of Underwriting, Clinical, Actuarial and utilization analyses
Performing trend analytics
Healthcare Economics Consultant Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Healthcare Economics Consultant
List any licenses or certifications required by the position: AHIMA, AAPC, CCSP, CPC
Education for Healthcare Economics Consultant
Typically a job would require a certain level of education.
Employers hiring for the healthcare economics consultant 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, Health, Biostatistics, Health Services, Mathematics, Epidemiology, Public Health, Health Administration
Skills for Healthcare Economics Consultant
Desired skills for healthcare economics consultant include:
Healthcare administrative data
Medicare
Statistical methods used in the evaluation of healthcare claims data
Data and the systems that generate it
Claims processing
APC
CMS regulations and specifications in regards to Medicare Advantage risk adjustment
CPT FFS any value based compensation
Healthcare cost and quality topics
Healthcare industry
Desired experience for healthcare economics consultant includes:
Knowledge of fiscal planning exercises
SQL, SAS and VBA programming experience a plus
At least a Intermediate level proficiency with SQL or other statistical programs
Intermediate proficiency in SAS
At least an advanced proficiency level with MS Excel (Pivot tables, VLOOKUP)
Intermediate with SQL, ORACLE or other statistical programs
Healthcare Economics Consultant Examples
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Healthcare Economics Consultant Job Description
Job Description Example
Our growing company is hiring for a healthcare economics consultant. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for healthcare economics consultant
- Present findings and collaborate with business partners
- Serves as subject matter expert on capitation contract information available for various claims platforms (primarily NICE platform, NDB / COSMOS Capitation)
- Lead audit support
- Proactively identifies medical expense trend opportunities and risks throughout the plan such as trend anomalies, outliers, behaviors
- Research key business problems through quantitative analysis of utilization and healthcare costs data
- Identify potential data issues and variances in source data
- Analysis review
- Analysis prioritization
- Analyze data to identify savings opportunities
- Contribute to work effort to retrofit to contribute to current SAS programs to point to new target data warehouses Adept at understanding data nuances between data warehouses and writing customized programming language to address the nuances
Qualifications for healthcare economics consultant
- Advanced level of proficiency with SQL – writing complex sub-queries, table design, creating stored procedures
- At least a foundational level of knowledge of Access, SQL and/or other database programs
- At least an intermediate level of proficiency with MS Excel (Pivot tables, VLOOKUP)
- At least an intermediate proficiency with Microsoft Excel to include pivot tables, foundational formulas, charts
- A bachelor’s degree in the areas of Economics or Statistics or other field relevant to data analysis with a minimum GPA of 3.4
- Minimum of 2 years of prior work experience in a data analytics role
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Healthcare Economics Consultant Job Description
Job Description Example
Our growing company is hiring for a healthcare economics consultant. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for healthcare economics consultant
- Develops and analyzes restated financial reports providing notations of performance deviations and anomalies
- Collaborates and coordinates with associates throughout the company to share ideas including plan cost-savings, opportunities, analysis techniques and models, data issues and general knowledge
- Independently develops sound models and analyses necessary to efficiently measure, understand, monitor and explain the company’s medical cost structure and restated financial results
- Validates Health Plan’s cost savings initiatives ensuring consistent and established analytical methods and standards
- Support enterprise data platforms through testing, training and coordinating with Decision Support department
- Acts as end-user expert fielding questions from Corporate and Health Plan users
- Maintenance of different operations and outcome reports and address issues raised by users
- Develop or enhance process/outcome monitoring/analysis reports
- Conducted ad hoc research/investigation per client or manager’s request
- Uses analytic tools to track both health risks and compliance, supporting the contract negotiation process
Qualifications for healthcare economics consultant
- An understanding and interest in manipulation and analysis of data
- Skills and experience in data visualization
- Ability to learn and thrive in a project-driven environment with time-sensitive deliverables
- Prior experience in a data analytics role, preferably within a research organization
- Experience in complex data acquisition including scraping and munging techniques
- Proficiency in Stata
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Healthcare Economics Consultant Job Description
Job Description Example
Our company is hiring for a healthcare economics consultant. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for healthcare economics consultant
- Analyze, review, forecast, and trend Medicare cost and utilization data
- Subject matter expert in Medicare cost and utilization business concepts and data
- Client interaction with assigned Regional Leadership
- Presentation of analytic findings, root causes, and recommendations
- SQL - query creation and data extraction
- Identifies potential areas for medical cost improvements and alternative pricing strategies in collaboration with the Regional leadership team, key functional (clinical, network, actuarial and payment integrity) leaders and local Plan leaders
- Interpret and analyze claims, capitation, clinical data and membership data in support of Senior Leadership and Network Management analyses
- Build analytics models
- Report out/present key findings to HouseCalls leadership
- Develop sustainable analytics models and dashboards in Tableau
Qualifications for healthcare economics consultant
- Graduate-level preparation (MSN, MHA, MBA) preferred
- Experience in financial modeling, proforma development, value analysis, and other financial management
- A bachelor’s degree in the areas of Economics, Statistics, Mathematics or other field relevant to data analysis with a minimum GPA of 3.4
- Minimum 1 year of relevant work experience is required
- Experience with Excel and statistical programming packages such as STATA, Visual Basic, SAS, R, Matlab or Mathematica
- At least an intermediate level proficiency with SQL (inner and outer joins, sub-selects)
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Healthcare Economics Consultant Job Description
Job Description Example
Our company is growing rapidly and is looking for a healthcare economics consultant. 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 consultant
- Attention to data accuracy and validity
- Build strong relationships within the organization including finance, IT, product, actuarial/underwriting, clinical, and operations
- Effectively collaborate with a well-integrated UHG group engaged in a consulting arrangement with UHC finance
- Translate and communicate highly complex concepts in ways that can be understood by a variety of audiences including senior leaders
- Understand and explain drivers of healthcare trends
- Merge, enrich, analyze and validate disparate data with knowledge of healthcare and government policy to develop and communicate sound business recommendations to leaders throughout the organization
- Assist with complex analytic projects leveraging data from multiple sources
- Support development of financial and operational dashboards and key performance indicator reports to meet customer requirements
- Update market profiles on a quarterly basis
- Assist in the update of Network Efficiency Factors at a Unet market level, requested sales area levels, and 3 digit zip code level
Qualifications for healthcare economics consultant
- 3+ years of experience in health care analytics and working with large data sets preferred
- At least an intermediate level proficiency with SQL, SAS and/or other statistical programs - preferred
- 6 or more years of experience with advanced data analysis in managed healthcare, preferably dealing with Medicaid populations
- At least three years of experience leading large analytics projects
- Advanced SQL and/or SAS programming abilities in data warehouse or big data analytics environment, including use of statistical analysis techniques or business intelligence application development
- 2 or more years of experience in creating and using financial modeling tools, spreadsheets, and information acquisition tools including experience in interpreting and reviewing financial modeling results to evaluate the financial impact of contract changes and develop forecasts
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Healthcare Economics Consultant Job Description
Job Description Example
Our company is growing rapidly and is hiring for a healthcare economics consultant. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for healthcare economics consultant
- Manage requests for Discount and Access data using the Discount Tool
- Respond to emails and questions from Network Management, Network
- Pricing, Underwriting, and Sales
- Maintain relativity factors for all products to include in reporting packages for the team
- Update the UCRT on a monthly basis
- Contact for any UGAP data pulls as requested
- Serve as a liaison between external client/third party vendors and multiple internal data teams
- Work with subject matter experts and process owners to improve data quality while ensuring reports are submitted in a timely manner
- Review and approve remediation plans
- May serve dual roles as Project Manager and Data Analyst
Qualifications for healthcare economics consultant
- 3+ years’ experience in health care analytics is a plus, not a requirement - 1-2 years of experience is fine
- Must have SAS and SQL programming skills to read and write programs, queries, data manipulation, and troubleshoot independently
- Undergraduate degree or equivalent years of professional work experience
- Proficient with MS Excel for data analytics
- Bachelor's degree in Finance, Economics, Mathematics, Actuarial Science, Health Administration or another related field
- At least an intermediate level proficiency with SQL