Senior Analyst, Medical Economics Department: Medical Economics Employment Type: Full Time Location: 1668 S. Garfield Ave. 2nd Floor, Alhambra, CA 91801 Compensation: $101,712 - $109,000 / year Description Senior Analyst, Medical Economics (Astrana Health Management Inc.; Alhambra, CA) Key Responsibilities Mine data to uncover key analytical insights for decision support, with focusing on evaluating and improving financial and operational performance of Astrana Health’s health plan, institutional, and provider contracts. Build deal models for health plan, institutional, and provider contract negotiations, including Medicare Advantage, Commercial Risk, Medi-Cal, and Fee-for-Service. Identify cost-saving opportunities by analyzing physician authorizing/billing patterns in relation to hospital admissions, emergency room visits, office visits, referral practices, and specialty care procedures. Identify and investigate complex suspect areas regarding medical cost issues, initiate in-depth analysis and propose a corrective action plan. Perform pro forma sensitivity analyses to estimate the expected financial value of proposed medical cost improvement initiatives. Analyze claims and other data sources to identify early signs of trends or other issues related to medical care costs. Evaluate the financial impact of quality incentive contracts based on quality measure datasets (Annual Wellness Visits (AWVs), HEDIS (Healthcare Effectiveness Data and Information Set), and Hierarchical Condition Category (HCC)). Use data tools (SQL and Excel) to track, analyze, forecast, and report payor and hospital financial impacts. Identify, develop, and document audit findings to present to key stakeholders. Develop proprietary analytics infrastructure, including various reports and dashboards, supporting the company’s institutional and payor financial performance. Complete a variety of strategic adhoc projects on large data sets. Telecommuting permitted from within the U.S. #J-18808-Ljbffr Astrana Health, Inc.
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