Healthcare Analyst

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for. We're a team that owns our work with accountability, makes data‑driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. We are seeking a dynamic and experienced Healthcare Strategist to join Medica's healthcare economics team. This role is pivotal in developing and implementing data strategies that drive key business decisions within our organization. The ideal candidate will leverage data from various sources to enhance the use of healthcare data, industry standards, and benchmarks to inform key stakeholders and partners, ultimately improving financial performance, member experience, and patient outcomes. The strategist will also focus on industry trends in pharmacy and medical services, incorporating benchmarking practices to ensure competitive positioning. Responsibilities Data Analysis and Insight Analyze complex healthcare data to identify trends, patterns, and key performance indicators (KPIs) related to utilization, cost, quality, and member health status. Monitor and evaluate industry trends in pharmacy and medical services, including drug pricing, formulary management, and adherence strategies. Develop data‑driven insights to recommend strategic decisions regarding network development, product design, and risk adjustment strategies. Benchmarking and Performance Metrics Conduct regular assessments of industry trends in pharmacy and medical services (e.g., regulatory changes, payer strategies, and emerging therapies). Benchmark organizational performance against industry standards and best practices to identify opportunities for improvement and innovation. Conduct comparative analyses of Medica's performance against competitors and industry standards, providing insights on core performance KPIs (e.g., cost, rates, utilization, quality, NPS, and others). Business Impact and Reporting Create customized reports and dashboards to visualize key metrics, including benchmarking data against industry standards, and communicate actionable insights to stakeholders at various organizational levels. Collaborate with business teams to translate data insights into actionable strategies that improve patient care and enhance financial performance. Reporting and Technology Stay updated on emerging data technologies and analytics tools to enhance analytical capabilities. Evaluate and implement new data sources and platforms to support strategic initiatives, particularly in pharmacy and medical benchmarking. Present complex analytical concepts and results to both technical and non‑technical audiences, ensuring clarity and actionable insights. Collaboration and Partnerships Manage the lifecycle of data strategy and benchmarking projects and initiatives, including requirements gathering, scoping, resource planning and delivery. Collaborate with key stakeholders to define benchmarking projects and initiatives, deliverables, timing and identify opportunities to include in normal business cycles. Partner and represent Medica with key vendors on analytical benchmarking initiatives and projects. Continuous Improvement Stay abreast of healthcare trends, best practices and regulatory changes affecting benchmarking and healthcare analytics. Identify opportunities for process enhancements and promote a data‑driven culture within the organization. Population Health Management Identify high‑risk patient populations through data analysis and partner internally to develop targeted interventions to improve health outcomes. Monitor and evaluate the effectiveness of population health management programs using data analytics. Business Acumen Develop, document, and maintain operating playbooks, workflows, and standard operating procedures for analytics processes, ensuring consistent and well‑documented methodologies. Ensure compliance with all applicable laws and regulations in analytics practices. Perform other duties as assigned. Qualifications Bachelor's degree in Data Science, Mathematics, Healthcare Analytics, Healthcare Economics or equivalent experience in a related field; Master’s preferred. 7 years of work experience beyond degree in healthcare analytics or data‑driven roles within the healthcare or insurance industries with a focus on leveraging benchmarking tools and methodologies. Highly advanced working knowledge and skill of the professional field with ability to provide direction on very complex projects. Strong proficiency in data analysis tools (e.g., SQL, Python, R, Excel) and visualization techniques/software (e.g., Power BI, Tableau). Proven experience in developing and implementing data standards and best practices within an analytical environment. Proficiency in Microsoft Office applications including Word, PowerPoint, Excel, and Access. Demonstrated ability to design, evaluate, and interpret complex data sets, with strong analytical and problem‑solving skills. Excellent written and verbal communication skills, capable of conveying complex information clearly and concisely to diverse audiences. Experience working independently and collaboratively in cross‑functional teams, engaging with individuals from diverse professional backgrounds. Location & Compensation This position is an office role requiring onsite work, on average, 3 days per week. Candidates located near Minnetonka, MN, or Madison, WI are preferred. The full salary grade for this position is $88,800 - $152,300. The typical hiring salary range is expected to be between $88,800 and $133,245. Annual salary placement will depend on factors including education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. Medica offers a generous total rewards package that includes competitive medical, dental, vision, paid time off, holidays, paid volunteer time off, 401(k) contributions, caregiver services and many other benefits to support employees. Internal Applicants Internal applicants must have been in their current role for at least one year. Equal Opportunity We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment regardless of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic. #J-18808-Ljbffr