Healthcare Analyst - Hybrid NY

Work Schedule

• This is a hybrid position which consists of reporting to our 100 Church Street, NYC office on Tuesdays, Wednesdays & Thursdays.

Duties & Responsibilities:

• Analyze the financial performance of all Healthfirst products, identify favorable and unfavorable trends, develop recommendations to improve trends, and communicate recommendations to management.

• Create financial models to evaluate the impact of provider reimbursement changes

• Gather data and conduct ad hoc analyses as directed by other department team members and assist with the development and presentation of analytical data reports

• Support department projects related to medical cost reduction initiatives

• Assist with Return on Investment (ROI) analyses for vendors to determine if their financial and clinical performance is achieving desired results

• Keep abreast of New York Medicaid and Medicare reforms and their impact on Healthfirst and their owner hospital performance

Minimum Requirements:

• Bachelor's degree or higher from an accredited institution with a concentration in Finance, Accounting, Business, or Healthcare Administration

• Familiarity with key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRGs), Ambulatory Patient Groups (APGs), Ambulatory Payment Classifications (APCs), and other payment mechanisms

• Experience in modeling financial impact of provider reimbursement changes

• Self-motivated, creative problem solver who can work independently and collaborate through strong communication and interpersonal skills

• Strong project management experience and ability to handle multiple projects in a fast-paced environment.

• Knowledge of statistical methodologies and tools, including experimentation design

• Demonstrated success analyzing large datasets

• Excel (pivot table creation, complex formula development, sum-ifs, and VLOOKUP's

• SQL: Proficient - minimum 2-3 years of experience with ability to use aggregate & window functions, group by, temp tables, subqueries, CTEs and optimize queries involving complex joins with millions of rows of data.

• AWS: proficiency with Redshift and S3 or similar cloud data warehouse solutions

• Familiarity with data models and/or data modelling

• Experience with Alteryx, Tableau, Amazon Redshift, QlikView, or other similar tools/platforms

Preferred Requirements:

• Experience with analyzing medical cost and utilization trends

• Current or previous work experience with a Health insurance company

• Advanced skills in SAS

• Python: Familiarity (1 year)

• R: Familiarity helpful

• Knowledge of Medicaid and Medicare programs

• Provide support to the departments performance improvement work groups

• Monitor costs and revenue trends and assist in understanding trends

• Understand and analyze impacts of new program changes

• Utilize statistical tools to identify, analyze, and interpret patterns and trends in complex data sets

• Responsible for creating, modifying, and updating analysis for Provider Organizations

• Responsible for contract analysis and fee schedule modeling

• Maintain current project logs and work plans on assignments

• Additional duties as assigned

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.