Sr. Analyst, Medical Economics Details

Sr. Analyst, Medical Economics

Evolent Health - Brea, CA

Employment Type : Full-Time

It’s Time For A Change…

Your Future Evolves Here

Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving power that brings us to work each day. We believe in embracing new ideas, testing ourselves and failing forward. We respect and celebrate individual talents and team wins. We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans.

Are we growing? Absolutely. We have seen about 30% average growth over the last three years. Are we recognized? Definitely. We were named one of “Becker’s 150 Great Places to Work in Healthcare” in 2016, 2017, 2018 and 2019 and are proud to be recognized as a leader in driving important Diversity and Inclusion (D&I) efforts: Evolent achieved a 95% score on its first-ever submission to the Human Rights Campaign's Corporate Equality Index; was named on the Best Companies for Women to Advance List 2020 by Parity.org; and we publish an annual Diversity and Inclusion Annual Report to share our progress on how we’re building an equitable workplace. We recognize employees that live our values, give back to our communities each year, and are champions for bringing our whole selves to work each day. If you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a mission. Join a mission with a company behind it.

New Century Health merged with Evolent Health in 2018 and continues to guide transformative change in specialty care management as an Evolent company. Within the Evolent ecosystem of provider-centric solutions for value-based care, our New Century Health team focuses on cost and quality improvement for oncology and cardiology specialty care. With more than 15 years of proven results, New Century Health generates insights and drives cutting edge innovation through its clinical capabilities and deep appreciation of health care informatics, physician management and health care technology systems development. Together, Evolent and New Century Health are harnessing the power of our combined organizations to improve the health of the nation. Join the New Century Health team and put your passion to work for transforming the U.S. health care landscape for patients, providers, and payers.

Who You’ll Be Working With:

The Senior Analyst, Medical Economics utilizes and develops analytic tools to solve complex business challenges as well as support decision making that can have a considerable impact on the organization and patient health. This role supports both Medical Cost Management activities as well as Business Development efforts.

What You’ll Be Doing:

• Analyzing both internal and external datasets for client pricing, medical cost management, operational reporting, and general financial analysis
• Forecasting costs, investigating utilization trends, and creating financial models using claims and other healthcare data
• Developing descriptive and multivariate analytic algorithms, statistical models, and other innovative approaches to investigate problems, detect patterns, and recommend solutions
• Using programming skills to explore, examine and interpret large volumes of data in various forms to complete deliverables
• Consulting with, mentoring, and leading junior data analysts with proper documentation, programming, analyses, and data visualizations
• Collaborating with peers and other teams to gather requirements and develop action plans to complete time sensitive projects more efficiently/effectively as well as identify opportunities for improving the reliability and validity of analytic reports
• Communicating technical concepts and implications to internal/external business customers
• Analyzing prospective and current client utilization data to identify utilization trends, calculate cost of healthcare, and identify opportunities for New Century Health to add value to customers
• Collaborating with internal/external business customers to understand their problems and objectives, solve business questions, and help them to achieve goals by performing statistical analysis, developing analytic models, creating data reports/dashboards using a variety of performance metrics

The Experience You’ll Need (Required):

• Bachelor’s degree, preferably with a quantitative major (e.g. actuarial, statistics, operations research, mathematics, economics) or healthcare focus (health administration, epidemiology, public health, biology)
• 2-5 years of professional experience in claims-based healthcare analytics with a payer, provider, vendor, or related healthcare consulting entity
• Strong proficiency with SQL, SAS, and Microsoft Excel
• Ability to communicate clearly with diverse stakeholders to solve problems; ability to translate between business needs and analytical needs
• Exceptionally strong analytical abilities, with track record of identifying insights from quantitative and qualitative data

Finishing Touches (Preferred):

• Master's Degree, especially with a quantitative focus (e.g. data science, machine learning, statistics, mathematics, computer science, or engineering)

• 2+ years of Healthcare economics experience
• Knowledge of actuarial reserving methodologies
• Working knowledge of healthcare claims; specifically, differences between institutional vs professional billing and various sites of care/service
• Familiarity with healthcare reimbursement methodologies and calculations such as DRGs, Revenue Codes, CPT Codes, RVUs, bundled payments, etc.
• Familiarity with value-based care and utilization management
• Understanding of data systems and the critical thinking skills to solve new problems and adapt to changes in data architecture
• Experience with other languages/platforms such as Python, R, SQL, Hadoop, AWS, ArcGIS
• Experience with BI tools (e.g. Tableau, Power BI.), Visual Basic, and Microsoft PowerPoint

Technical requirements:

Currently, Evolent employees work remotely temporarily due to COVID-19. As such we require that all employees have the following technical capability at their home: High speed internet over 10 MBPS and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.

Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.