Senior Medical Economics Analyst

Senior Medical Economics Analyst

Job Location: 150 N. 18th Ave, Phoenix, AZ 85007

Salary: $70,000 – $75,000

Grade: 26

FLSA Status: Exempt

Closing Date: Open Until Filled

This position may offer the ability to work remotely, within Arizona, based upon the agency's business needs and continual meeting of expected performance measures.

Job Summary: AHCCCS is seeking a Senior Medical Economics Analyst to join the Office of Data Analytics within the Information Services Division. This position plays a key role in turning complex Medicaid data into clear, actionable insights that support decision-making across the agency. Help shape healthcare decisions for more than 2 million Arizona Medicaid members by using advanced analytics, and data storytelling to influence policy, to improve health outcomes, and identify opportunities to reduce healthcare costs across one of the nation's largest Medicaid programs. This role regularly partners with executive leadership, program leaders, and healthcare stakeholders to deliver insights that influence policy decisions, operational strategy, and statewide healthcare initiatives.

What You'll Do:

Analyze Medicaid claims, encounters, pharmacy, utilization, membership, demographic, provider, and other healthcare datasets to identify trends, risks, cost drivers, utilization patterns, quality outcomes, and opportunities for improvement. Conduct research and perform complex analyses to support business operations, healthcare programs, financial management, and strategic initiatives. Develop recommendations based on data findings and communicate implications to stakeholders. Develop, maintain, and enhance recurring and ad hoc reports, dashboards, scorecards, and key performance indicators that support business operations and executive decision-making. Monitor healthcare costs, utilization, quality measures, and program performance, ensuring accurate and timely reporting for internal customers, agency leadership, and other stakeholders. Provide analytical support for organizational initiatives by evaluating business problems, assessing operational and financial impacts, identifying improvement opportunities, and developing data-driven recommendations. Support long-term planning efforts through predictive analysis, trend identification, forecasting, and evaluation of program outcomes and effectiveness. Translate complex analytical findings into clear and actionable business insights for technical and non-technical audiences. Prepare executive summaries, presentations, data visualizations, and written recommendations that support informed decision-making. Present findings to business partners, management, and agency leadership and respond to follow-up analytical requests. Partner with internal business units, healthcare program teams, finance staff, operational leaders, and other stakeholders to understand business needs, define analytical requirements, and deliver meaningful solutions. Provide subject matter expertise on healthcare data, reporting methodologies, performance metrics, and analytical findings to support operational, financial, and strategic decisions. Promote data integrity, consistency, and appropriate use of healthcare data by supporting data governance, validation, documentation, and quality improvement activities. Utilize analytical and business intelligence tools, programming languages, healthcare coding systems, and healthcare data sources to ensure accurate analysis and reporting. Contribute to knowledge sharing, process improvement and departmental best practices.

Knowledge, Skills & Abilities (KSAs): Knowledge:

+ Healthcare data concepts, including medical claims, pharmacy claims, utilization management, skills and assignments demographic data, and healthcare coding systems.

+ Data analysis, data mining, reporting, analytics, and modeling of complex data sets.

+ Business intelligence and reporting tools such as IBM Cognos, Power BI, or equivalent platforms.

+ Data management concepts, practices, procedures, and data governance principles.

+ Medicaid, Medicare, managed care, encounter processing, and CMS related policy concepts.

Skill In:

+ Strong analytical, research, and problem-solving skills.

+ Excellent attention to detail and commitment to data quality.

+ Strong written, verbal, interpersonal, and presentation skills.

+ Strong customer service and business partner engagement skills.

Abilities:

+ Balance, prioritize, and organize multiple tasks and assignments.

+ Work collaboratively with teams across the agency and with external business partners.

+ Synthesize feedback and adjust analysis, reporting, or communication approaches as needed.

+ Build strong working relationships inside and outside the organization.

+ Organize data in ways that support meaningful inference, conclusion, and decisions.

+ Understand and anticipate the needs and priorities of internal and external customers.

+ Support small to medium teams, as assigned.

+ Develop clear reports, dashboards, summaries, and presentations that support decision making.

Qualifications: Minimum:

- Bachelor's degree in Mathematics, Statistics, Economics, Finance or healthcare related discipline and/or 10 years of experience in business analysis, healthcare analytics, medical economics, data analysis or closely related field. Experience working with healthcare data including but not limited to medical claims data, Medicaid data, Medicare data, or similar healthcare datasets. Experience querying, summarizing, and manipulating data using SQL, SAS, Python, R, Machine Learning methods, Cognos, PowerBI, or similar technologies. Strong ability to analyze complex datasets and communicate findings in a clear and actionable way.

Preferred:

- Master's degree in Mathematics, Statistics, Economics, Finance or healthcare related discipline. Medicaid or Medicare experience especially with claims, encounter, utilization, pharmacy.