Medical Economics Analyst job opening Ewing, New Jersey

AurionPro Solutions Leading Global IT Consulting Services.

We’ve Urgent requirement with one of our client for Medical Economics Analyst job opening Ewing, New Jersey

Position Title: Medical Economics Analyst

Duration: Full Time

Location: Ewing, New Jersey

Job Overview:

The position is responsible for the preparation of the company’s quarterly MCR By County/ Fee For Service Trend reports, identification and reporting of medical cost drivers and outliers, and evaluation of medical cost savings opportunities.  This position is also responsible for measuring and monitoring HNJH project financial metrics including ROI and evaluating the feasibility of new business opportunities.  Responsible for analyzing and presenting causes for changes in the cost of care related to professional, inpatient, outpatient pharmacy and ancillary services.  Support various departments by preparation and analysis of standard and adhoc reporting to identify cost drivers and monitor cost savings due to various medical cost reduction initiatives.

Responsibilities:

·     Development and implementation of analytic tools and techniques to identify cost of care drivers

·     Interprets results and makes recommendations that result in cost reduction and bottom line improvement

·     Identifies through data analysis medical cost savings opportunities

·     Preparation of reports on medical costs to determine trend, risks, and opportunities related to medical performance

·     Responsible for monitoring and reporting results of medical cost strategies

·     Assists in the review and evaluation of Medicaid premium rate proposals from the State of  New Jersey

·     Develops, monitors and measures department policies and procedures to ensure consistent utilization reporting. Employs appropriate techniques to ensure data integrity

·     Responsible for incorporating metrics and benchmarks (both internal and external) to proactively identify and evaluate both leading and trailing indicators of medical management/health services processes (including HEDIS and Care Management) and resulting cost, utilization, and quality trends

·     Responsible for development and oversight of models for evaluation of provider performance/incentive compensation management

·     Assists with fraud & abuse prevention efforts through data analysis

Skills and Abilities:

·     Requires proven quantitative and financial analysis skills

·     Requires the ability to express thoughts clearly and concisely, both verbally and in writing

·     Requires demonstrated ability to work in a team environment and get results

·     Requires attention to detail and granular levels of financial reporting

·     Requires a demonstrated aptitude for analytical thinking and the ability to report findings in an accurate manner

·     Requires the ability to research and resolve problems through interaction with company-wide personnel

·     Requires outstanding organizational skills including the ability to plan, organize and prioritize work assignments

·     Requires the ability to work independently with minimal direct supervision and exercise sound business judgment

·     Requires proficiency with SA and Microsoft Office products including XL and Access

·     Requires technical skills with database concepts, data analysis development, data warehousing, and decision support tools.

Education and Experience:

·     Bachelor’s degree in accounting, finance or a related field and prefer masters level degree

·     Minimum of 2-5 years of experience in health care/managed care with direct responsibility for medical analysis and management

·     Requires understanding of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, product pricing, network and provider contracting, and utilization management

Regards,

Vignesh - Sr. Talent Acquisition, Aurionpro

Phone: 408-754-6161 / e mail: vignesh.renikuntla@aurionpro.com

Linkedin: http://www.linkedin.com/in/viggy1