Medical Economics Consultant Senior | Remote

　　Location: Newtown Square, PA

　　Primary Job Function: Finance

　　ID**: 29713

　　Your career starts now. We’re looking for the next generation of health care leaders.

　　At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

　　Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

　　Discover more about us at www.amerihealthcaritas.com.

　　Responsibilities:

　　The position of Medical Economics Sr. Consultant reports to the Manager of Medical Economics & Business Process within Actuarial Analytics. This position is primarily responsible for leading the development of large reporting layers, reports, executive decks, & enhanced metrics for our Total Cost Of Care (TCOC) revenue & expense review process. Additional responsibilities include meeting the business on actionability from insight by helping develop High Value Opportunities (HVO’s) that are in the millions of dollars in savings/revenue added & validating ongoing initiative savings methodology & accounting. Sr. Consultants have strong technical backgrounds & will create tools & reports that draw on disparate datasets, provide professional infrastructure, and generate a complete picture of our medical expense & revenue trends for primarily Medicaid by member cohort & claim category through the use of industry standard KPI. Sr. Consultants have strong business knowledge in Medicaid Managed Care & are expected to work with operational matrix partners to understand business processes in place to ensure reporting relevancy in addition to presenting findings to senior leadership in a clear & concise manner. Technology competencies include Azure Databricks, SAS, Python, MS SQL Server, Tableau, MS Power BI, Excel Data Models, or equivalent technologies.

　　Education/ Experience:

　　Bachelor’s Degree in Computer Science, IT, IS or related field strongly preferred OR equivalent combination of education and work experience will be considered.

　　5 to 10 years Related Experience with at least 3 years working in Medical Informatics, Medical Economics, or related analytical positions at Managed Care Organizations.

　　Other Skills:

　　Excellent communication skills

　　Mastery of enterprise approaches to either MS SQL Server & related RDBMS technologies or MS Azure & related cloud computing data lake solutions

　　Mastery of SQL

　　Demonstrated experience creating mega reporting projects & associated infrastructure from master data layers to enhanced clinical metrics that drive action

　　Strong knowledge of the anatomy of healthcare claims and/or encounters

　　Strong knowledge of health informatics terminology & classification schemes i.e. CPT codes, ICD-10 dx, common groupers like DRG’s, CCS, etc.

　　Strong knowledge of industry standard population health & quality KPI like utilization per thousand, readmission rates, HEDIS metrics, etc.

　　Strong knowledge of Excel and SAS EG on Unix

　　Strong knowledge of a visualization tool like Power BI or Tableau

　　Strong interest in Medicaid

　　Diversity, Equity, and Inclusion

　　At Amerihealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

　　We keep our associates happy so they can focus on keeping our members healthy.

　　Our Comprehensive Benefits Package

　　Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k), Tuition reimbursement, and more.

　　EOE Minorities/Females/Protected Veterans/Disabled