Medical Economics Analyst
Steward Health Choice Utah is dedicated to improving the health and well-being of the people and communities we serve.
Steward Health Choice Utah believes in a personal approach to health care right in your community. We built our health care plan around you. Our goal is to give you quality health care, programs, and services to support you on your path to wellness.
Steward Health Choice Utah provides exceptional customer service and culturally competent care through:
- Compassionate and responsive member services team
- Collaboration with community physicians to help members get the health care they need.
- Providing culturally competent health care, including extensive translation and interpretation services
- Health programs to help members and their families stay healthy
Position Purpose: The Medical Economics Analyst is responsible for collecting, analyzing and interpreting health care data including claims, capitation, member, and provider information. This position completes analyses required to proactively support medical management activities, provider contracting and management activities, financial and accounting activities, and other senior leaders of the company. The Medical Economics Analyst provides key information critical to decision making, leveraging advanced spreadsheet, development, and database skills to deliver value to key stakeholders.
Major Functions and Essential Duties:
- Design and develop reports and analyze data to measure clinical outcomes, network performance and methodology levers
- Develops medical cost reporting, including standardization of cost categories of service, unit cost and utilization metrics
- Assists in development of business requirements for decision support tools and reports
- Create dashboards generated from trend data, utilization authorization, risk adjustment, and claims data to support departmental functions
- Models hospital, physician and ancillary contracts in order to advise network contractors during rate negotiations, as well as provide monthly analysis of overall network performance
- Displays a high level of critical thinking to address complex business problems. Creates actionable information and effectively communicates results that support findings to customers
- Collaborates with internal and external partners to understand data needs and design analytic studies that provide actionable results
- Supports Medical and Financial programs through monitoring and tracking of initiatives
- Proactively identifies potential areas for medical cost improvements and alternative pricing strategies
- Maintains and distributes monthly reports to members of the senior leadership team including refreshing of standard reports as well as designing and providing ad hoc reports upon requests
- Receive, interpret and complete data requests from Finance and other departments
- Reports and other requests are generated, maintained, distributed, and presented in a timely, organized, accurate, and effective manner
- Other duties as assigned based on business need
Education / Experience / Other Requirements
- College degree (BS or Associates) in MIS, Computer Science or commensurate analytical experience
Years of Experience:
- At least two (2) years data analysis experience, preferably in a health care field
- Knowledge of HIPAA transactions are preferred
- Knowledge of Medicare and Medicaid regulations and reporting requirements
- Advanced knowledge of Microsoft Excel and Access
- Microsoft SQL experience
- Analytical and organizational skills
- Accomplish goals with minimal supervision
- Be comfortable learning new software programs and company systems independently
Equal Opportunity Employer Minorities/Women/Veterans/Disabled
Steward Health Care Network is taking additional, necessary preparations to ensure patients can receive compassionate care in a safe, carefully managed environment – with confidence and without fear.
Our Safe and Ready program consists of a rigorous [three-point] standard ensuring patient safety, confidence and convenience:
- Any COVID-19 related care takes place in designated areas away from other patients and their families.
- A stringent cleaning policy has been implemented throughout our facilities.
- A strictly controlled visitor and masking policy is required for patient and colleague safety.
You can rest assured that we have made the necessary preparations to provide care in a safe, controlled and professional way.