Medical Economics Analyst, Sr

Location: New York or Houston

Reports to: Sr. Director, Finance

Department: Finance

Assist in the development and presentation of timely, accurate, actionable data and analysis supporting the department, regional market, and corporate key initiatives. Participate as a liaison with regional market operations. Provide analytics for strategic and operating decisions to senior management. Provide proactive analysis and recommendations to senior management on both tactical and strategic nature.

Essential Functions:

  • Proactive involvement with identification, evaluation and monitoring of medical cost savings initiatives.
  • Provide analysis of medical cost trends/drivers associated with the monthly MBR reporting in conjunction with the release of the monthly reports
  • Participate in and/or facilitate identification, valuing and monitoring of company sponsored medical cost initiatives
  • Link and explain historical results versus the financial forecast related to the initiatives
  • Provide reliable and accurate MBR reporting
  • Work with the technical team to identify/implement improvements in quality control/timeliness of reporting
  • Work with business owners to help markets understand their financial information
  • Provide analysis of material changes in MBR levels from month to month in conjunction with the release of the monthly reports
  • Link MBR reporting (recast) and financial forecast results
  • Know the business
  • Contribute to cross-functional teams to address key issues facing the organization.
  • Collaborate within finance (Actuarial/Accounting/Planning) to provide historical and prospective unit cost, utilization and other medical cost initiatives as critical inputs to the financial forecasting and monitoring process.
  • Build expertise in specific areas of medical cost management. Leverage this expertise across other markets and regions.
  • Coordinate and participate in research-related activities including industry best-practices, research and development of models, tools, and data analysis projects, and experience studies.
Additional Responsibilities:
    Candidate Education:
    • Required A Bachelor's Degree in
    Candidate Experience:
    • Required 2 years of experience in Financial /Data Analysis with a Bachelors Degree in Information Systems/Management, Computer/Data Science, Statistics, Mathematics, Informatics, Business, Economics or a closely related analytic field - OR -
    • Required 4 years of experience in Financial /Data Analysis with a Bachelors in any other field of study
    Candidate Skills:
    • Advanced Demonstrated analytical skills
    • Intermediate Ability to identify basic problems and procedural irregularities, collect data, establish facts, and draw valid conclusions
    • Intermediate Ability to work in a fast paced environment with changing priorities
    • Intermediate Demonstrated organizational skills
    • Intermediate Other Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables
    • Intermediate Other Ability to remain calm under pressure
    Licenses and Certifications:
    A license in one of the following is required:
      Technical Skills:
      • Required Intermediate Microsoft Word
      • Required Intermediate Microsoft Excel
      • Required Intermediate Microsoft Outlook
      • Preferred Intermediate Other Knowledge of relational database concepts and designs
      • Preferred Intermediate Other SAS / SQL or similar database querying tool
      • Preferred Intermediate Other Healthcare data and systems

        About us
        Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses exclusively on providing government-sponsored managed care services through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans to families, children, seniors and individuals with complex medical needs. WellCare is a Fortune 500 company, and in 2018, was recognized as a Fortune "World's Most Admired Company", ranking in the top five among the health insurance and managed care industry-a testament to the hard work and dedication of the company's nearly 9,000 associates who each day live WellCare's values and deliver on its mission to help its members live better, healthier lives. The company serves approximately 4.4 million members nationwide as of Dec. 31, 2017. For more information about WellCare, please visit the company's website at EOE: All qualified applicants shall receive consideration for employment without regard to race, color, religion, creed, age, sex, pregnancy, veteran status, marital status, sexual orientation, gender identity or expression, national origin, ancestry, disability, genetic information, childbirth or related medical condition or other legally protected basis protected by applicable federal or state law except where a bona fide occupational qualification applies. Comprehensive Health Management, Inc. is an equal opportunity employer, M/F/D/V/SO.