Sr. Medical Economics Analyst
New
E
Ennoble CareHealthcare
Fully RemoteFull-TimeSenior
Salary not disclosed
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Job Details
- Experience
- 3-5 years
- Required Skills
- SQLMicrosoft AzureMicrosoft ExcelEHRData analytics
Requirements
- Bachelor's degree in Data Science, Statistics, Mathematics, Economics, Business Administration, or related quantitative field.
- 3-5 years of data analytics experience, preferably in healthcare or Medicare-focused environments.
- Thorough understanding of and hands-on experience with Medicare risk adjustment and CMS-HCC models.
- Demonstrated experience working with CMS and CMMI total cost of care (ACO) programs.
- Proven track record analyzing Medicare claims data, specifically CCLF and BCDA datasets.
- In-depth knowledge of healthcare billing processes from both provider and CMS perspectives.
- Advanced proficiency in Microsoft Excel (pivot tables, complex formulas, VBA preferred).
- Strong SQL skills with the ability to write complex queries and optimize database performance.
- Experience with Microsoft Azure cloud platform and related analytics tools.
- Proven ability to work with very large datasets (multi-million row files).
- Experience integrating EHR data with claims datasets.
Responsibilities
- Develop and maintain sophisticated risk-adjusted provider group performance models using CMS-HCC methodology.
- Analyze VBC performance under various CMS and CMMI total cost-of-care models.
- Monitor and forecast financial performance across assigned patient populations.
- Conduct comprehensive claims analysis using CCLF and BCDA datasets.
- Process and analyze large healthcare datasets, combining multiple data sources including EHR systems.
- Create analytical reports and executive dashboards for leadership and clinical stakeholders.
- Collaborate with revenue cycle and coding teams to optimize documentation and billing accuracy.
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