Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015. The Medical Economics Analyst provides decision support and recommendations to management through detailed and complex analyses of healthcare trends, measurement of cost of care performance, and quantification of the impact or effectiveness of projects and programs. The analyst partners with business leadership by providing insight into trends and the value of programs/initiatives using medical cost analytics to drive action.
- Identifies, monitors, and analyzes health care cost drivers, including utilization, cost, provider billing practices and reimbursement rates
- Prepares business-related analyses and research findings on utilization, financial and quality performance data to establish and track against organizational targets, and identifies trends and opportunities for improvement
- Identifies medical cost savings opportunities for internal teams and provider partners to pursue
- Recommends policy changes and claims system changes to pursue cost savings
- Reviews results of initiatives or actions post-implementation to ensure projected cost savings are realized and recommends modifications as needed
- Recommends standardized practices to optimize cost of care management
- Provides analytical consulting in support of value based contracting strategy
- Assists in developing innovative analytic capabilities for medical cost driver pattern identification
- Works with Operations to ensure financial integrity is achieved and maintained from the provider contract to the actual claim adjudication
- Supports network management department in evaluating contract terms with respect to health plans, hospitals and providers
- Provides support to leadership in developing cost of care budgets and trend projections for CMS Bids, DHA Rate Negotiations, and other initiatives
- Conducts complex quantitative analyses using tools such as SQL, Cognos, Access and Excel
- Exhibits initiative in exploring and discovering opportunities to improve corporate performance through data analysis
- Presents analyses/reports in clear and useful format to management and colleagues in other departments
- Other duties as assigned
- BS/BA degree; preferably in Economics, Mathematics, Statistics, or related field
- 5+ years’ experience in broad-based analytical, managed care payor or provider environment
- Comprehensive understanding of provider reimbursement, including fundamental healthcare billing and coding concepts
- Experience with hospital charge masters and health system revenue management cycle strategies preferred
- Experience navigating and analyzing public (e.g., national and state-specific) health care claims data sets and prepared reports preferred
- Master’s degree preferred
- Demonstrates an understanding of and alignment with Martin’s Point Values.
- Proven ability to thrive in fast-paced, deadline-driven work environments
- Strong analytical and troubleshooting skills
- Strong interpersonal skills
- Proven ability to influence, work, collaborate, and communicate globally with peers
- Proficient computer skills, Microsoft Office Suite; working knowledge of program/project management software (Basecamp, MS Project)
- Knowledgeable in program management methodology and techniques; performance evaluation and change management principles
- Excellent verbal and written communication skills
- Able to multi-task, prioritize, and manage time effectively
- Able to prioritize a variety of projects and resources raging in size and scope to meet objectives and deadlines.
- Excellent at managing internal and external client relationships.
We are an equal opportunity/affirmative action employer.
Do you have a question about careers at Martin’s Point Health Care? Contact us at: firstname.lastname@example.org