We are seeking a dynamic Senior Health Economics Analyst to join our team! This highly visible role empowers you to spearhead the development of detailed analyses, tackle complex challenges, and collaborate with stakeholders across the enterprise.  Your contributions will support decision-making processes and demonstrate the value proposition of our business.  

Responsibilities will include:

· Extract, summarize, and analyze large medical claims and clinical datasets from multiple sources. Develop efficient queries, communicate complex findings clearly, and create compelling narratives for decision makers. 

· Perform complex opportunity analyses to identify program savings and conduct ROI analyses identifying favorable and unfavorable trends to validate whether financial and clinical performance is achieving the desired results. 

· Engage with customers and business partners to gather requirements, document assumptions, and develop concise presentations for both technical and non-technical audiences. 

· Interface with clients to understand their payment methodologies, governmental requirements, etc. to provide data analysis using industry standards. 

· Identify and perform root-cause analysis of data irregularities. Present data-driven insights and recommendations to both internal and external stakeholders, soliciting and incorporating feedback as needed. 

· Make autonomous decisions regarding analytical approaches and confidently defend them under scrutiny.? 

· Prepare client facing summaries using business intelligence tools to help highlight program performance and areas of concern.  

· Assist in data governance and data management processes. 

· Other duties as assigned 

Qualifications

  · 5+ years progressive experience in the healthcare industry in medical economics, provider finance, healthcare analytics or similar role working with very large medical claims datasets to analyze financial, operational, and utilization metrics to meet various information needs across different products or markets.  Job level commensurate with experience.

· Demonstrated proficiency in SQL for data retrieval, manipulation and analysis as well as experience building visualizations and dashboards in Tableau. 

· Proficiency with Microsoft Excel (formulas, pivot tables, etc.) 

· Knowledge of coding used in medical claims billing (ICD-10, CPT/HCPCS, bill types, revenue codes) as well as comprehension of provider reimbursement principles and methodologies. 

· Advanced problem-solving and research skills, attention to detail, and the ability to make critical, independent decisions within area of responsibility. 

· Excellent time management and the ability to prioritize work and complete assignments within their allotted deadline. 

· Ability to work independently and draw up plans to address issues/concerns as well as part of a team. 

 · Ability to interact effectively with different business units, team members, and external clients at all levels. 

· Strong communication skills to simplify complex scenarios into key takeaways and present clear, concise presentations (both verbally and visually,) of the detailed analytics as well as the ability to explain and drill into any given detail behind the analyses you develop.? 

· Ability to thrive in a dynamic environment quickly adapting to change and navigating ambiguity to drive results. 

  Preferred: 

· Strong understanding of the insurance industry including knowledge of payer operations (i.e., claims processing, UM/CM, eligibility processes, risk adjustment) preferred. 

· Product mindset in the approach to analytics with expertise in quantitative analysis, data mining, and the presentation of data to anticipate how customers will interact with deliverables. 

· Certification in or experience with project management.

Company Description/Benefits

ProgenyHealth empowers our health plan and employer partners to change the trajectory of maternal and infant health outcomes across America. Our end-to-end maternal and infant care management solution helps ensure the best possible outcomes for every expecting mother we touch. Our wholly integrated solution builds a network of support for an uninterrupted continuum of care from prenatal health, through any resultant NICU stay, and all the way to one full year of life. We help overcome systemic barriers to support healthier pregnancies and healthier starts to life for all moms and babies, one family at a time.

Some of the benefits we offer our team are:

• Paid Time Off
• Paid Parental Leave
• Medical, dental, vision benefits
• 401K with company match
• Short- and Long-Term Disability
• Group Life Insurance
• Tuition reimbursement
• Professional development opportunities
• Business Casual work environment

 ProgenyHealth positively recruits people from diverse backgrounds, including individuals with disabilities - if you need an accommodation to interview, please contact us by email: careers@progenyhealth.com

 All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status.