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.
Sr. Healthcare Economics Analyst
Summary:
- Work with other team leaders to improve operational efficiencies and resource allocations for improved performance of the EmblemHealth plans.
- Responsible for running queries and providing required analysis to understand related drivers (such as medical cost and utilization), and to provide insightful commentary and sensitivity modeling analysis.
- Develop data-driven analysis for decision making on how EmblemHealth purchases, manages, and influences the cost of care for current and prospective members.
- Extract, analyze, and interpret data for more complex insights related to cost drivers and to manage the escalation of issues that impact costs, and impact of health cost containment initiatives.
- Provide consultative subject matter expertise to aligned business areas to demonstrate analytics rooted in data.
Responsibilities:
- Ensure data integrity is maintained throughout the reporting lifecycle.
- Implement reporting and reconciliation workflows and document processes.
- Responsible for experience studies and medical trend studies.
- Perform research and collection of data, including data mining and reporting, which is provided to various customers inside and outside the department.
- Implement automation of manual reporting and analysis of business implications and trends.
- Lead efforts to continually improve data capabilities and quality of department analysis and reporting.
- Create, develop, and design analytics and reporting to measure or estimate financial impact of health plan business problems and potential or actual solutions, addressing escalated issues with subject matter expertise.
- Lead and manage several corporate and health cost containment initiatives, supporting staffing to deliver results across all functions within Medical Economics including.
- Develop research and analytic processes to review financial data to draw conclusions for senior leadership.
- Represent the department to internal and external partners with presentation of data and results for use in administering specific programs and processes related to medical expense and utilization.
- Present analytical findings to internal business partners, leading discussions and providing delivery of further analysis.
- Analyze business problems related to financial experience of the health plan, particularly related to how care is purchased, managed, or other factors influencing cost of care.
- Perform additional duties as assigned.
Requirements:
- BA/BS in Mathematics, Statistics, Economics, Healthcare or related discipline required; Master’s preferred
- 4 – 6+ years’ experience working in a healthcare setting (within a provider health system or health insurance company) required
- Ability to query, summarize, and manipulate data using SQL or SAS required
- High level of proficiency with MS Office (Word, Excel, PowerPoint, Outlook, etc.), with an emphasis on Excel required
- Experience working with healthcare data including but not limited to claims, testing results and pharmacy data required
- Strong communication skills (verbal, written, presentation, interpersonal) required
- Experience preparing/presenting dashboards and data using a data visualization tool such as Tableau 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, gender identity, pregnancy, marital status, national origin, disability, veteran status, or any other protected characteristic protected by law.
Sponsorship Statement
EmblemHealth may provide work visa sponsorship depending on factors such as business unit requirements, position nature, costs, and applicable laws and regulations.