Healthfirst

The Manager Product Analytics, Medical Economics will monitor financial performance and provide analytic insights for all products offered within the Healthfirst portfolio. At times this leader could be called upon to manage the daily operations of high value projects for the company to ensure predetermined goals are met for the project. The ideal candidate will come from a managed care, insurance or actuarial background and will be a results-oriented individual who enjoys working in a fast-paced and challenging environment. ~Hybrid Work Schedule consists of reporting to our 100 Church Street, NYC office 3 days per week~

Scope of Responsibilities:

• Monitor cost and utilization trends, provide concise insight into the root cause drivers, and develop potential remediation opportunities.  
• Provide data driven analysis to Finance, Claims, Medical Management, Network, and other departments to enable critical decision making.
• Develop savings analyses for Medical Economics cost trend reduction initiatives, applying financial modeling expertise and using independent judgement to determine best valuation methods.
• Create financial models to evaluate the impact of provider reimbursement changes.
• Keep abreast of New York Medicaid and Medicare reforms and their impact on Healthfirst and their owner hospital performance.
• Manage and train a team of analysts.
• Perform ad hoc analyses.

Minimum Qualifications:  

• Bachelor’s Degree from an accredited institution.
• 4+ years of experience in the managed care industry related to analytics.
• Extensive knowledge of managed care financial metrics (PMPM, util/k, cost/unit).
• Experience utilizing healthcare claims data to uncover valuable insights to improve financial performance.
• 3+ years of proven work experience with SQL where you have created queries, pulled large data sets and performed data manipulations/analysis.
• Extensive experience with Microsoft Excel (building financial models, utilizing pivot tables, vlookups, index match, and calculated fields).
• Experience with data visualization and reporting techniques using tools like Tableau, Power BI, or similar.
• Ability to work with large data sets.
• Strong written and verbal communication skills.
• Work experience in a supervisory/leadership role and ability to train, mentor and manage a team of Analysts.
• Resourceful and creative in solving complex issues and working corroboratively with others on a solution.
• Ability to manage projects and project plans within stated timelines.
• Exceptional stakeholder management skills, with a proven ability to collaborate and influence across functions.
• Advanced problem-solving skills and the ability to make critical, independent decisions within area of responsibility.

Preferred Qualifications:  

• 5+ years of experience in the managed care industry related to analytics.
• Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG’s), Ambulatory Patient Groups (APG’s), Ambulatory Payment Classifications (APC’s), and other payment mechanisms.
• Understanding of value-based risk arrangements.
• Master’s degree in mathematics, computer science, data science, engineering, business analytics, or similar field.
• 5+ years  proven work experience with SQL.
• 2+ years of working experience with Python.
• Familiarity with the AWS ecosystem, specifically Redshift.
• Experience with Git/versioning control for managing code changes and collaboration.

Hiring Range*:

• Greater New York City Area (NY, NJ, CT residents): $131,900 - $190,570

• All Other Locations (within approved locations): $117,400 - $174,675

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.