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Clinical Affairs Economic Analyst Lead

  • Job ID: 378137001
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Health Plan
  • Department: INS Payer Provider
  • Location: Work From Home
  • Union Position: No
  • Salary Range: $38.32 to $64.85 / hour

Description

UPMC Health Plan is currently Hiring a Clinical Affairs Economic Analyst Lead in the Insurance Payer Provider department. This is a full time position working Monday through Friday daylight hours and will be a remote position.

The Clinical Affairs Lead will manage comprehensive analysis of data and information for various UPMC Health Plan products and programs. Health Economics Analysts will take a leadership role in the enhancement, development, documentation, and communication of identified variances and assessment of strategic opportunities. To successfully perform the role, the Health Economics Analyst must be highly professional and understand the causes of financial & clinical trends and anomalies. The Health Economics Analyst must use their knowledge and understanding of financial, clinical and other information generated by numerous sources to identify opportunities to improve clinical and financial performance. Furthermore, the position requires the ability to articulate these opportunities to internal and external audiences, implement the solutions, and track and monitor progress. These functions must be done while also weighing the practical considerations and potential barriers that need to be overcome in order to successfully implement new programs and processes.

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.
  • Routinely analyze financial and clinical results, including output from predictive models.
  • Engage directly with managers and directors in other business functions to advise regarding analytics project specifications, as a representative of DOHE leadership.
  • Independently prioritize and manage 5-or-more 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.
  • Demonstrate leadership in development of analysis plans for multiple, complex projects to be carried out by the HEA ? Lead or team members.

 

 

Qualifications

Minimum:

  • Bachelor's degree in business, mathematics, statistics, health care management, decision sciences, or a similar, quantitative field.
  • Master's degree preferred.
  • Minimum of four-to-six years of work experience in a quantitative job function; seven years are preferred.
  • 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.
  • Prior experience with financial and/or clinical modeling or data analysis is required.
  • Demonstrate prior application of analytics methods specifically to health insurance or health care delivery industry data at the senior analyst level.
  • 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.

Licensure, Certifications, and Clearances:

  • Act 34

  • UPMC is an Equal Opportunity Employer/Disability/Veteran

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