Senior Medical Economics Analyst

Summary

Join Homeward in revolutionizing healthcare delivery in rural America! We are seeking a Senior Medical Economics Analyst / Senior Actuarial Analyst passionate about using technology to address health inequities. You will join our Medical Economics team, supporting the actuarial function through data analysis, financial impact assessments, and infrastructure development. This role involves utilizing medical claims, clinical, and operational data to improve financial and operational performance, forecasting, and reporting on value-based contracts. You will collaborate with cross-functional teams and communicate findings to both technical and non-technical audiences. This position offers a competitive salary, comprehensive benefits, and a flexible work arrangement.

Requirements

• 5 years of experience in actuarial or medical economics work, specifically healthcare-related
• Experience with medical and pharmacy claims, EMR data, and CMS Risk Adjustment files
• Understanding of value-based care programs for Medicare Advantage, Medicaid, or other healthcare plans
• Strong Excel skills
• Experience with analytics tools such as SQL, R, or Python and data visualization tools (Tableau, Power BI, etc.)
• Collaborative spirit and ability to drive analyses with technical and non-technical stakeholders
• Ability to zoom in with attention to detail and also zoom out to see the big picture
• Ability to interpret complex data sets, identify trends, and generate meaningful insights for decision-making
• Strong communicator of questions, challenges, opportunities, and results to technical and non-technical audiences
• Bachelor’s degree in actuarial science, mathematics, economics, statistics, or a related field

Responsibilities

• Use medical claims, clinical, and operational data to provide recommendations for improving financial and operational performance
• Employ advanced data tools to track, analyze, forecast, and report on the financial impact of payor contracts
• Analyze healthcare utilization patterns and cost trends to identify key drivers of medical expenses and opportunities for cost containment
• Build robust analytical infrastructure, including comprehensive reports and dashboards, to monitor payor financial performance
• Stay ahead of industry trends impacting contracting, such as payor market share, star rating changes, bid strategies, and reimbursement trends
• Conduct a variety of analyses related to benchmarking, contract optimization, investor relations, risk adjustment, and more
• Work closely with teams across Analytics, Data, Contracting, and Operations

Preferred Qualifications

Progress toward actuarial credentials (ASA/FSA)

Benefits

• Competitive salary, equity grant, generous paid time off
• Comprehensive benefits package including medical, dental & vision insurance with 100% of monthly premium covered for employees
• Company-sponsored 401k plan
• Flexible working arrangement