Job Summary

• Supports the medical cost position of assigned markets through analysis of healthcare provider contracts, analysis of high performing network solutions, analysis of medical expense reports, data drill downs of trend drivers, and execution of key initiatives designed to address medical expense and product pricing trends.
• Partners with network management and pricing units to deliver medical expense results in line with trend/cost expectations to ensure strong competitive positioning within the marketplace.
• Provide analytical and strategic support of health care provider rate negotiations.

Matching Summary

Skills & Requirements

Key Requirements

• Bachelor's degree in Statistics, Mathematics, Economics, Health Policy Analysis, Finance, or other related field of study
• 5+ years of experience with health care data analysis
• Experience with medical cost trend analysis
• Experience with health care provider contract analysis
• Technical sophistication with various data mining and business intelligence tools such as SAS, SQL, Microsoft Access, or similar products
• Advanced Microsoft Excel skills
• Knowledge of standard medical coding including CPT-IV, ICD-10, DRG, revenue codes, and HCPCS

Work Rights