Job Information
Trinity Health REMOTE Senior Medical Economist Analyst in Conshohocken, Pennsylvania
Employment Type:
Full time
Shift:
Description:
Provides specialized technical and analytical support for Trinity Health's Payer Strategy & Product Development department. Work assignments are complex and responsibility requires in depth knowledge of financial and clinical analyses and cost and utilization trends related to payers, employers, and health plan data as well as strong analytical, investigative, interpretive and evaluative skills and the ability to contribute to and provide primary accountability for managing/leading small projects or portions of projects is expected. Responsibilities include, but are not limited to, analyzing the financial and operational impact of fee for service contract changes for hospital, physician and ancillary providers. Assignments may require interfacing with, gathering information from and making presentations to various levels of management and internal and external executive leaders. Serves as a subject matter expert and resource by providing guidance and problem/issue resolution to internal colleagues on matters impacting projects and day-to-day assignments.
ESSENTIAL FUNCTIONS
Knows, understands, incorporates, and demonstrates the mission, vision, and values of Trinity Health in behaviors, practices, and decisions.
Participates in development of alternative payment model tools to analyze, evaluate and interpret data. Designs analytical tools and health care data exports for Payer Strategy & Product Development. Plans processes, systems, policies, regulations and internal controls documents.
Conducts complex impact analyses and modeling, assesses utilization trends, identifies risks, develops projections, determines opportunities and prepares detailed written recommendations and summaries for management review and decision-making.
Utilizes claim valuation application, integrated financial systems, relational databases, business intelligence and desktop analytical reporting tools to access and manipulate data and develop detailed standard and ad-hoc reports and summaries that support department projects and initiatives.
Develops the design and implementation of evaluation tools to measure the effectiveness of both internally developed medical management initiatives and externally purchased vendor programs. Tests and refines tools used to support Payer Strategy & Product Development.
Develops and implements plans to measure and report on system-wide health care delivery cost and utilization trends; collaborates with system experts in developing sound methodology for forecasting trends including participation on analytic team(s).
Participates in and serves as a subject matter expert in the development of process improvement initiatives which support business needs and enhance the performance of payer claims analysis, product development and the managed care contracting process. Gathers and exchanges information and provides guidance and problem resolution on complex, challenging and variable situations that demand deep analytical, interpretive and evaluative thinking.
Participates in defining project plans and goals; manages and/or leads small projects or portions of projects with focused impact. Performs business case ROI, conducts business workflow mapping and impact analysis, applies actions steps, provides routine status reports and keeps management apprised ensuring project plans and deliverables are met.
Plays a prominent role in the development and maintenance of standard Payer Strategy & Product Development databases, data definitions, reporting tools, policies and procedures.
Understands and builds analytic tools on the Payer Strategy & Product Development analytic platform. These tools will be used to manipulate large data sets, conduct system/data integrity and quality checks/audits, access applications and utilize relational database management or systems administration methods and practices.
Maintains a working knowledge of applicable Federal, State and local laws/regulations; the Trinity Health Integrity and Compliance Program and Code of Conduct; as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.
Performs other duties as needed and assigned, including advanced ad hoc analytics such as modeling of contract and benefit scenarios. Utilizes statistical applications as necessary.
MINIMUM QUALIFICATIONS
Bachelor’s degree in Computer Science, Healthcare Business Informatics, Math, Statistics, Economics or related field or an equivalent combination of education and related experience. Master's or preferred.
Five (5) to seven (7) years of progressively responsible operational or consulting experience in managed care data, programming, advanced analytics and payer analytics reporting. Knowledge and experience gained from health plan, health system, the healthcare industry or a provider health network is required.
Knowledge of relational database principles and coding, examples include: SQL, Cognos, PowerPlay, and Business Objects. Application development principles preferred.
Business knowledge of healthcare systems and health insurance products and operations or the willingness to obtain such knowledge through continuing education and course examinations offered by American Health Insurance Plans (AHIP) and the Healthcare Financial Management Association (HFMA).
Advanced proficiency with Microsoft product suite (MS Word, Excel, Power Point, Access and Visio), financial systems/software, relational database management and business intelligence reporting tools.
Must possess a high degree of analytical, quantitative, evaluative and problem solving skills.
Considerable knowledge and experience supporting and developing reporting and analytics for research, process improvement support and ability to develop appropriate methods to collect, analyze and report data.
Strong attention to detail and organizational skills. Demonstrated ability to manage multiple, concurrently running projects and adapt to changing deadlines, competing priorities and unexpected assignments.
Knowledge of medical terminology and coding methodologies including HCPC, CPT, RBRVS, Diagnosis (ICD-10), DRG's required.
Excellent interpersonal and group facilitation skills, oral and written communication skills.
Ability to manage/lead large projects or portions of projects. Ability to work independently and with minimal supervision. Ability to work in a team environment providing support to multiple positions. Ability to resolve problems and complete assignments accurately and promptly. Ability to meet deadlines, multi-task, problem solve and use appropriate technology to analyze business problems.
Demonstrated ability to respect confidential and sensitive information, understanding and honoring lines of accountability and communication is essential.
Ability to operate in an ambiguous and matrix organizational structure. Ability to operate in a highly autonomous self-directed manner under frequently changing structures, requirements and priorities.
Must be comfortable operating in a collaborative, shared leadership environment.
Must possess a personal presence that is characterized by a sense of honesty, integrity and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals and values of Trinity Health.
Compensation Range: $39.82 - $59.73
PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS
Must be able to set and organize own work priorities, and adapt to them as they change frequently.
Must be able to travel to the various Trinity Health sites as needed (up to 10%).
Must possess the ability to comply with Trinity Health policies and procedures.
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of duties so assigned.
Our Commitment to Diversity and Inclusion
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.
Our Commitment to Diversity and Inclusion
Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.
Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.
EOE including disability/veteran