Health Economics Analyst, Lead - Provider Analytics

Role Description

The UPMC Health Plan is seeking a Health Economics Analyst to lead the analysis of financial and clinical data to identify variation, inform strategy, and drive improved performance across UPMC Health Plan products and programs. This role will be focused on provider analytics, leveraging episode-based methodologies to compare cost, efficiency, and quality across providers.

The Health Economics Analyst Lead will develop deep expertise in analytical tools and outputs, translate insights into actionable opportunities, and communicate effectively to internal and external stakeholders. Success in this role requires strong analytical judgment, intellectual curiosity to explore and identify potential use cases, and the ability to influence decision-making and drive measurable improvement.

• Become increasingly familiar with basic medical claims terminology to interpret the impact of care delivery and finance on Health Plan performance.
• Independently prioritize and manage up to 5 advanced quantitative and/or statistical analytics projects simultaneously, with minimal supervision.
• Produce customer-oriented reports that provide business context for the analysis and recommendations, requiring only moderate revision.
• Routinely apply advanced data extraction and manipulation skills, complex analysis methods, statistical analysis, and data visualization tools.
• Independently, or in teams, produce a combination of quantitative financial analysis and clinical utilization analysis to generate 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.
• Develop knowledge and expert understanding of all products and benefit designs of UPMC Health Plan insurance offerings across all lines of business.
• Maintain professionalism and a team-player attitude in a fluid, dynamic, fast-paced environment.
• Consistently demonstrate a strong customer orientation, producing analyses on-time and communicating results effectively.

Qualifications

• Bachelor's degree in business, mathematics, statistics, health care management, decision sciences, or a similar quantitative field; Master's degree preferred.
• Prior experience with financial and/or clinical modeling or data analysis is required.
• Minimum of four-to-six years of work experience in a quantitative job function; seven years preferred.
• Demonstrated prior application of analytics methods specifically to health insurance or health care delivery industry data at the senior analyst level.
• Demonstrated expertise in particularly relevant analytical methods or health care business domain (payer/provider) may reduce time-in-position requirements.
• 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.

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.
• Interpret and communicate to management and colleagues, verbally and through written reports, the results of complex, quantitative analysis.
• The successful HEA Lead will have Senior analyst-level experience using SQL, SAS, or R to conduct analysis; 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.

Company Description

UPMC is an Equal Opportunity Employer/Disability/Veteran.