Health Care Economics Analyst

Professional SME responsible for claim trend analytics and cost containment program evaluation and measurement across all Markets.   Cost containment evaluations can include but will not be not limited to programs/policies related to medical management, clinical edits, provider payment and pharmacy policies.   

Professional will participate in content creation for Monthly Trend Report Out for Business Leadership that informs key drivers of claims trends and opportunities for exploration / remediation efforts.  Professional will develop and report regularly on KPIs related to cost containment programs and or vendor guarantees.  

Professional will advance team capabilities and use cases for predictive analytic models to aid in strategic business decisions.

Remote work environment; must be in Eastern or Central time zone

ESSENTIAL JOB FUNCTIONS:

• Collaboration with the team leader, peers and key stakeholders across the organization
• Research and query multiple data sources, manipulate large sets of data using appropriate tool
• Identify and Implement the most efficient solution for the business problem with forward thinking mindset to leverage automation and efficiency
• Leverage AI, Machine Learning or Statistical software where appropriate to advance analytics
• Validation of data, data models and reporting for accuracy and soundness
• Actively seek to draw inferences from the data to drive actionable insights/strategic discussions
• Actively seek to understand the why and how to add value to business request vs. just doing the request
• Actively challenge the status quo and find a better way
• Develop solutions that enable a positive and productive user experience for self service access to data assets
• Present Finding, Model or Report to Business / Leadership effectively and persuasively
• Manage multiple priorities and deliver in timely manner
• Active learning of MVP's data assets, products, markets to enable applying business mindset to decision making and reporting solutions

QUALIFICATION REQUIREMENTS

• Minimum of 3 years of experience in Health Care Analytics Role (or Advanced degree in math or statistics and at least 1 year of experience working with Health Care data)
• Foundational knowledge of MVP's markets and products and awareness of competitive landscape
• Working knowledge of MVP Data assets including claim, pharmacy, member and provider data. Ability to access, query and analyze disparate data sources.
• Working knowledge of Provider Billing / Reimbursement methodologies
• Demonstrated ability to independently gather all relevant information, probe, challenge and confirm business problem with team leader and / or key stakeholder
• Proficiency in Microsoft suite of products including Power Platform
• Proficiency in SQL
• Working knowledge of Phython or R with understanding of business use cases
• Effective verbal and written communication skills.  Ability to inform and educate business stakeholders on key issues/results related to work product.

About MVP

MVP Health Care is a nationally recognized, not-for-profit health insurer caring for members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve.

At MVP, we are committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. Specific employment offers and associated compensation will be made individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the nature of and demand for the role.

In addition, we offer a comprehensive benefits package that includes:

• Considerable paid time away from work including PTO (Paid Time Off), sick time, service time off, paid holidays, and floating holidays, allowing you to take time off when it suits you best.
• Competitive 401(k) employer matching and profit-sharing program to help you save for your retirement.
• Low premium health benefits including medical, dental, and vision coverage to support your well-being and that of your family.
• Life insurance and disability coverage to ensure financial security for you and your dependents.
• An array of optional benefit plans such as accident insurance and specified disease coverage to protect you from the unexpected.
• Full tuition reimbursement (up to the IRS limit) for approved courses and programs that support continuous learning.
• A best-in-class employee Well-Being program to support all dimensions of your health and wellness.

MVP Health Care analyzes the latest market data to determine employee compensation. Compensation figures listed in a job posting are subject to change as new market data becomes available. The salary range, other compensation, and benefits information is accurate as of the date of this posting. MVP Health Care reserves the right to modify this information at any time, subject to applicable law. More detailed information about totalcompensation and benefits will be provided during the hiring process.

MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the Know your Rights protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com
 

Please apply and learn more – including how you may become a proud member of our team.