Medical Economics Consultant (Medicare) - REMOTE

Company: Sacred Heart University
Location: Fairfield
Posted on: May 6, 2025

Job Description:

Medical Economics Consultant (Medicare) - REMOTERecruitment began on January 31, 2025and the job listing Expires on May 25, 2025Provides consultative support and medical cost-based analysis of markets and network initiatives. The Medical Economics Consultant manages conflicting priorities and multiple projects concurrently. Responsible for extracting, analyzing, and synthesizing data from various sources to identify risks and opportunities as well as packaging and delivering the results to senior leadership. Responsible for consulting with network and clinical management on opportunities to improve our company's discount position and strategic cost and utilization initiatives.Knowledge/Skills/Abilities

• Analyze and research utilization and unit cost medical cost drivers
• Turn data into usable information by tell the story through data visualization working with clinical, provider network and other personnel to bring supplemental context and insight to data analyses
• Support the development of scoreable action items by identifying outlier cost issues
• Perform drill-down analysis to identify medical cost trend drivers; advise network of contracting opportunities to mitigate future trends
• Own, track and document all aspects of related work from beginning to end of a project
• Extract and compile information from various systems to support executive decision-making
• Ability to mine and manage information from large data sources
• Working with Excel, MS-Access and Web-based query tools (data warehouse)Job QualificationsREQUIRED EDUCATION:Bachelor's Degree in Finance, Mathematics, Statistics, or EconomicsREQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:5 - 7 years in healthcare/managed care industry with knowledge of provider contracting, provider reimbursement, patient management, product, benefits design, or related experience.PREFERRED EDUCATION:Master's Degree in Business Administration, Finance, Mathematics, Statistics, or EconomicsPREFERRED EXPERIENCE:Experience working with medical and pharmacy claims, authorization data, benefits design, medical management as well as knowledge of business functions and impact on financials (underwriting, sales, product development, network management.)To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.#PJCorp#LI-AC1Pay Range: $80,412 - $188,164 / ANNUAL
  *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.About UsMolina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
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Keywords: Sacred Heart University, Novato , Medical Economics Consultant (Medicare) - REMOTE, Healthcare , Fairfield, California