Health Economics Analyst, Lead - Provider Analytics (Remote)
Pittsburgh, Pennsylvania, United States · Remote OK
Senior$459K raised
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Skills: Provider Analytics, Financial Modeling, Clinical Data Analysis, SQL, SAS
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Lost Time Claims Specialist II (VA, MD, PA, and DC)
Pittsburgh, Pennsylvania, United States · Remote OK
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Full-time
bachelor degree, postgraduate degree
Posted 22d ago
~40 hrs/week
Remote in Pittsburgh, Pennsylvania, United States
Responsibilities
Lead the analysis of financial and clinical data to identify variations and drive performance across UPMC Health Plan products. Develop episode-based methodologies to compare provider cost, efficiency, and quality while communicating insights to stakeholders.
Requirements
Requires a Bachelor's degree in a quantitative field and 4-7 years of experience in quantitative analysis, preferably within the healthcare or insurance industry. Proficiency in SQL, SAS, or R is required for conducting complex statistical and business analyses.
Full job description
Purpose: The UPMC Health Plan is seeking a Health Economics Analyst to lead the analysis of financial and clinical data to identify variation, inform strategy, and drive improved performance across UPMC Health Plan products and programs. This role will be focused on provider analytics, leveraging episode-based methodologies to compare cost, efficiency, and quality across providers.
The Health Economics Analyst Lead, will develop deep expertise in analytical tools and outputs, translate insights into actionable opportunities, and communicate effectively to internal and external stakeholders. Success in this role requires strong analytical judgment, intellectual curiosity to explore and identify potential use cases, and the ability to influence decision-making and drive measurable improvement.
Responsibilities:
The quantitative analyst will also become increasingly familiar with basic medical claims terminology in order to properly interpret, through the application of quantitative analytics, the impact of care delivery and finance on Health Plan performance.
Independently prioritize and manage up to 5 advanced quantitative and/or statistical analytics projects simultaneously, while receiving minimal supervision.
Produce customer-oriented reports that provide business context for the analysis and recommendations, requiring only moderate revision by the supervisor or analytics communications team.
Routinely apply advanced data extraction and manipulation skills, complex analysis methods, statistical analysis, and data visualization tools to daily work.
Independently, or in teams, produce a combination of quantitative financial analysis and clinical utilization analysis to produce new insights into drivers of Health Plan performance.
Demonstrate attention to detail and initiative in discovering errors in data or analyses, or determining the need for additional, follow-up analysis arising from the original assignment.
Develop knowledge and expert understanding of all products and benefit designs of UPMC Health Plan insurance offerings, across all lines of business, to facilitate analysis.
Health Economics is a fluid, dynamic, fast-paced environment. The successful employee is comfortable with ambiguity in priorities and is able to maintain professionalism and a team-player attitude in the face of analytical challenges of moderate-to-high complexity.
The HEA Lead will consistently demonstrate a strong customer orientation, producing analyses on-time and communicating results effectively.
Bachelor's degree in business, mathematics, statistics, health care management, decision sciences, or a similar, quantitative field. Master's degree preferred.
Prior experience with financial and/or clinical modeling or data analysis is required.
Minimum of four-to-six years of work experience in a quantitative job function; seven years are preferred.
Demonstrate prior application of analytics methods specifically to health insurance or health care delivery industry data at the senior analyst level.
Demonstrated expertise in particularly-relevant analytical methods or health care business domain (payer/provider) may reduce time-in-position requirements.
The successful HEA Lead can apply analytical and statistical software tools to produce complex, quantitative analyses of the health insurance industry.
Work typically includes the use of statistical analyses, predictive models, or dynamic business models.
Demonstrate consistent application of strong problem-solving skills in the creation and interpretation of quantitative analyses, and to assist the supervisor in development of analysis plans.
Interpret and communicate to management and colleagues, verbally and through written reports, the results of complex, quantitative analysis.
Ability to leverage leading-edge analytics experience gained in other industries (e.g., population segmentation, risk analysis, optimization analytics, real-time analytics) to advance health care analytics will be strongly considered in lieu of health care experience.
General knowledge of business and economic principles strengthens the application.
The successful HEA Lead will have Senior analyst-level experience using SQL, SAS, or R to conduct analysis, i.e., prior experience independently programming complex business or statistical analyses is required.
Demonstrated application of a similar programming language or analysis tool such as SPSS, STATA, or C++ may also be acceptable.
UPMC is an Equal Opportunity Employer/Disability/Veteran
UPMC is a world-renowned, nonprofit health care provider and insurer committed to delivering exceptional, people-centered care and community services. Headquartered in Pittsburgh and affiliated with the University of Pittsburgh Schools of the Health Sciences, UPMC is shaping the future of health through clinical and technological innovation, research, and education. Dedicated to advancing the well-being of our diverse communities, we provide nearly $2 billion annually in community benefits, more than any other health system in Pennsylvania. Our 100,000 employees — including more than 5,000 physicians — care for patients across more than 40 hospitals and 800 outpatient sites in Pennsylvania, New York, and Maryland, as well as overseas. UPMC Insurance Services covers more than 4 million members, providing the highest-quality care at the most affordable price. To learn more, visit UPMC.com.
Offices: US Steel Tower, 600 Grant Street, Pittsburgh, PA 15219, US
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