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Sr. Medical Economics Analyst

4 weeks ago
Anywhere
Full-time
Mid Level
Business Intelligence Analyst
Data Science and Analytics
Azure HIPAA SQL
Apply Now
Ennoble Care

Ennoble Care

Ennoble Care provides personalized at-home primary, palliative, and hospice care, ensuring that individuals receive compassionate support in the comfort of their own surroundings.

Health Care Providers & Services
51-250
View All Jobs 10

Description

  • Develop and maintain risk-adjusted provider group performance models using CMS-HCC methodology.
  • Analyze value-based care performance under CMS and CMMI total cost-of-care models.
  • Monitor and forecast financial performance across assigned patient populations.
  • Conduct claims analysis using CCLF and BCDA datasets, including CMS-HCC risk adjustment simulations.
  • Process and analyze large healthcare datasets from EHR systems and Medicare claims data.
  • Ensure data quality and integrity across analytical processes.
  • Create analytical reports that turn complex actuarial findings into actionable business insights.
  • Develop executive dashboards and performance metrics aligned with strategic goals.
  • Present findings and recommendations to leadership teams and clinical stakeholders.
  • Support budget planning and financial forecasting processes.
  • Stay current with CMS and CMMI program requirements and quality measures.
  • Collaborate with revenue cycle and coding teams to improve documentation and billing accuracy.

Requirements

  • Bachelor's degree in Data Science, Statistics, Mathematics, Economics, Business Administration, or a related quantitative field.
  • 3-5 years of data analytics experience, preferably in healthcare or Medicare-focused environments.
  • Hands-on experience with Medicare risk adjustment and CMS-HCC models.
  • Experience working with CMS and CMMI total cost of care (ACO) programs.
  • Experience 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, including pivot tables and 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 and combine data from multiple sources.
  • Experience integrating EHR data with claims datasets for population health analysis.
  • Ability to maintain strict confidentiality and work with sensitive healthcare information in accordance with HIPAA and other regulations.

Benefits

  • Fully remote work with up to 10% travel.
  • Medical, dental, and vision coverage.
  • Supplementary benefits including life insurance, short-term and long-term disability, and FSA options for medical and dependent care.
  • Accident, critical illness, and hospital indemnity coverage.
  • Paid time off.
  • Paid office holidays.
  • Paid sick time.
  • 401(k) with up to 3% company match.
  • Referral program.
  • Payactiv pay-on-demand access to earned wages.

Interested in this position?

Apply directly on the company website

Apply Now

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