Medical Economics Analyst – Remote

Opportunities with ProHealth Physicians, part of the Optum family of businesses. When you work at ProHealth Physicians, your contributions directly sustain the health and well-being of our community. Discover high levels of teamwork, robust medical resources and a deep commitment to exceptional care and service. Join a leading community-based medical group and discover the meaning behind Caring. Connecting. Growing together.  

 

The Optum East is a region in the Optum nationwide network, comprised of several multispecialty groups Across Optum New York, New Jersey, Connecticut and Massachusetts. We bring patients local care, backed by national expertise. As a premier provider of health care services, The Optum East offers services including primary care, urgent care, a diverse range of specialty care, outpatient surgery, and imaging.

 

Together, for better health, Optum is committed to providing the highest standard of comprehensive medical care in a patient-centered and compassionate environment, with the comfort and convenience of being close to home.

 

If helping people live their healthiest lives is attractive to you, Optum is the place to be!

• We value work-life balance and have flexible on-site and remote non-clinical opportunities available.
• We believe in employee development, professional growth and company longevity.
• Our culture is one of mutual respect, teamwork and equality.
• Competitive salary, great benefits, and other attractive incentives.

 

Position Overview: The primary goal of the Medical Economics Analyst is to use data science, actuarial principles, and proprietary applications to enhance patient health and physician performance in value-based payment models. This role reports to the Senior Director of Population Health Analytics and collaborates with the Director of Network Contracting to design, produce, validate, and distribute key analytics related to claims, revenue, and quality. The analyst will investigate business problems through quantitative analysis of healthcare utilization and claims data, interpreting and analyzing clinical and payer data from various sources to provide insights to stakeholders.

 

If you are located in Northeast US, you will have the flexibility to work remotely* as you take on some tough challenges.

 

Primary Responsibilities: 

• Develop analytical tools and data reports to monitor progress on health outcomes and medical cost trends.
• Analyze savings, medical costs, and utilization drivers, providing insightful commentary and sensitivity modeling.
• Build relationships with key business areas to identify analytical needs and recommend improvements for disease management, case management, and utilization review programs.
• Manage data from key payers, including Medicaid, Medicare, and commercial insurers.
• Evaluate alternative payment models and innovative risk-sharing arrangements.
• Manipulate and transform complex data sets from multiple internal and external sources.
• Perform hands-on tasks such as data acquisition, transformation, analysis, and communication of findings.
• Design and deploy financial models to measure and predict financial and quality performance across multiple payer contracts.
• Apply advanced analytical methods to improve decision-making and strategic direction.

 

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. 

Required Qualifications: 

• Bachelor’s degree in quantitative disciplines (mathematics, statistics, economics, etc.), or related field
• 3+ years of analytical or actuarial work experience within the healthcare industry (i.e. consulting, hospitals, managed care organization, etc.)
• Experience with any of the following:  SSRS/SSIS packages, Python, R, Azure, Alteryx, or Visualization (Tableau/Power BI)
• Experience with healthcare analytics, informatics, and population health concepts
• Experience working with large databases, e.g. health insurance claims databases, data warehousing, and/or database administration
• Familiarity with claims / encounter data, as well as Medicare / commercial reimbursement methodologies 
• Proficiency in SQL (SSMS, preferred)
• Proven solid analytical and problem-solving skills
• Proven solid communication skills, including an ability to communicate with staff at various levels, including both front line staff and senior management

 

Preferred Qualifications: 

• Applied experience with EMR data & clinical analytic processes
• Solid understanding of Medicare Advantage plans and value-based incentive programs

 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy 

 

The salary range for this role is $59,500 to $116,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

 

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.   

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. 

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.