Company Statement
EmblemHealth is one of the nation’s largest not for profit health insurers, serving members across New York’s diverse communities with a full range of commercial and government-sponsored health plans for employers, individuals, and families. With a commitment to value-based care, EmblemHealth partners with top hospitals and doctors, including its own AdvantageCare Physicians, to deliver quality, affordable, convenient care. At over a dozen EmblemHealth Neighborhood Care locations, members and non-members alike have access to community-based health and wellness guidance and resources. For more information, visit emblemhealth.com.
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Lead Healthcare Economics Analyst (Network/Provider Contract Analysis)
REMOTE
Summary of Position
- Provide guidance to a team of financial analysts who provide timely, accurate, actionable data and analysis supporting the department, other business areas, and corporate key initiatives.
- Proactively initiate and develop analytics for strategic and operating decisions and provide recommendations to senior management.
- Design and lead development of data-driven analysis for decision making on how EmblemHealth purchases, manages, and influences the cost of care for current and prospective members.
- Analyze, and interpret data to produce insights related to cost drivers, opportunities to impact costs, and impact of health cost containment initiatives.
- Provide consultative support to aligned business areas to demonstrate analytics rooted in data.
Principal Accountabilities
- Design and lead execution of analytics and reporting to measure or estimate financial impact of health plan business problems and potential or actual solutions.
- Provide leadership across all functions within Healthcare Economics including monitoring of specific corporate and health cost containment initiatives.
- May lead/mentor less experienced staff.
- Research and analyze financial data to draw conclusions and provide consultation to internal and external partners for use in administering specific programs and processes related to medical expense and utilization.
- Provide guidance and subject matter expertise to perform complex analyses; serve as point of escalation to resolve the most complex issues.
- Present analytical findings to internal and external business partners.
- Plan, conduct and direct work on complex projects/programs related to financial experience of the health plan, particularly related to how care is purchased, managed, or other factors influencing cost of care.
- Advise management in long-range planning for areas of specialization.
- Perform additional duties as assigned.
Qualifications
Education, Training, Licenses, Certifications
- BA/BS Required in Mathematics, Statistics, Economics, Healthcare or other related discipline required; Master’s preferred.
Relevant Work Experience, Knowledge, Skills, and Abilities
- 5 – 8+ years of relevant, professional work experience. (Required)
- Experience working in a healthcare setting (within a provider health system or health insurance company). (Preferred)
- Experience working with healthcare data including but not limited to claims, testing results and pharmacy data. (Required)
- High level of proficiency with MS Office (Word, Excel, PowerPoint, Outlook, etc.), with an emphasis on Excel. (Required)
- Strong communication skills (verbal, written, presentation, interpersonal). (Required)
- Experience preparing/presenting dashboards and data using a data visualization tool such as Tableau. (Preferred)
- Ability to query, summarize, and manipulate data using SQL or Python. (Required)
Security Disclosure
If you receive a job offer from EmblemHealth, the email will be from “HRTalentAcquisition” with the subject: “Offer of Employment for (job title) – Please respond online.” We will never ask you to join a Google Hangout, buy your own equipment, or pay to apply. We also do not use third-party email services like Yahoo or Gmail.
Pay Disclosure
At EmblemHealth, we prioritize transparency in our compensation practices. We provide a good faith estimate of the salary range for potential hires, which is based on key factors such as role responsibilities, candidate experience, education and training, internal equity, and market conditions. Please be aware that this estimate doesn’t account for geographic differences related to your work location. Typically, new hires may not start at the top of this range, as compensation is tailored to each individual's circumstances. For union positions, salaries will be determined according to the collective bargaining agreement. Join us at EmblemHealth, where your contributions are valued and supported by fair compensation.
EEOC Statement
We value the diverse backgrounds, perspectives, and experiences of our workforce. As an equal opportunity employer, we consider all qualified applicants for employment regardless of race, color, religion, sex, sexual orientation, age, creed, citizenship status, gender identity, pregnancy, marital status, national origin, disability, veteran status, or any other protected characteristic protected by law.
Sponsorship Statement
At EmblemHealth, we are committed to building a diverse and talented workforce. However, we are unable to consider applicants who require, or are likely to require, either before or after hire, visa sponsorship for work authorization in the United States, including but not limited to H-1B, F-1 (STEM OPT), TN, or any other non-immigrant status. Some extremely rare exceptions may apply based on critical business needs.