Health Care

applicant

Sr. Health Economics Analyst (Clinical)Incredible opportunity to directly impact this growing organization's financial success. Utilize your expertise in data analysis, medical management and claims. Coordinate and manage health economics models and health services outcome studies and  conduct opportunity analysis and outcome reporting for disease management programs and pharmacoeconomics data analysis. Coordinate and prioritize data and analysis requests across health plans and corporate customers. Identify and communicate synergies in information and analysis needs among customers. Working with Health Plan and Corporate customers, identify and prioritize based on business value, the recurring and ad hoc data, information and analysis needs of the Health Plan to enable them to manage their medical costs and ensure delivery of quality healthcare to their members.  Coordinate analysis and development initiatives with cross plan initiatives and capabilities. Perform analysis and reporting to support the Health Plan and Corporate.  Support the Medical Management department by examining data integrity, analyzing outside vendors models and establishing pharmacy profiles of high utiliziers. Integrate pharmacy and medical data components for products and special programs.  Conduct opportunity analysis on disease management programs and perform health care outcome analyses projects. o Manage the process for changes to Outcomes Analysis Reports and maintain outcome reporting as it related to CQI initiatives. Manage, analyze and report on clinical, financial and health care outcomes data using analytical software such as Access or SAS and present findings to internal and external customers.  Manage the development efforts, with our technical team liaisons, including business requirements gathering and documentation, testing, delivery and user adoption, effectively communicating deliverable expectations to the Health Plan.Knowledge/Experience: Bachelor's degree in related field (Master's degree preferred), 4-6 years experience in health sciences research or health data analysis, clinical expertise (RN) could be a good candidate. Knowledge of statistics and application of higher level mathematical models in medical and pharmacy claims data. Basic understanding of health insurance business, claims payment procedures, strategies and trends in health care government program. Knowledge of medical management required. Must be experienced in Business Objects or Cognos and enterprise wide applications.  Excellent communication skills required.  ABOUT THE COMPANY:Our client is one of America's premiere managed medicaid companies.  They have operations in 10 states and over $900 million in revenue.  You'll enjoy a comprehensive benefits program, very competitive salary and generous bonuses.  ABOUT OUR FIRM:Health Career Professionals, LLC is a health care executive search and talent management firm who provides professional services to health care professionals and companies.  Our clients are national and regional health care plans who seek the services clinical and operational professionals in contract, interim, and permanent positions.By applying to this position you are agreeing to receive additional information from our firm and our periodic email newsletter about new opportunities and career information.  Your personal information is NEVER released to any third parties.