Medical Economics Analyst

Job description

This role requires a minimum of 3 days per week working in the Jacksonville FL office. SUMMARY OF JOB DUTIES: Medical Economics Analyst / Senior Analyst will be responsible for working with Medicare Advantage and DCE membership files to produce panel reports, identify new and termed members, and other Medicare Advantage/DCE membership reporting. ESSENTIAL JOB FUNCTIONS: - Must be proficient in using SQL Server - Consolidates monthly patient rosters from payers and disseminates standardized list to various departments (Value Based, Finance, Market Clinical Operations, etc.). - Develops monthly process to identify new and termed members and work across multiple data systems to consolidate demographic details. - Communicates with operational teams to meet their data and reporting needs. - Tracks business requirements from payers regarding cost reallocations and monitors case outcomes. - Develops monthly processes and procedures for identifying candidates for potential cost reallocations and completes accompanying forms, if applicable, for payer submission. - Obtain and analyze data to understand how to continually improve processes, procedures and execution. - Maintain knowledge of cu...