Job Description

Location: Remote, USA (No HI or AK)
Schedule: Must support CST/EST stakeholders
PST candidates must work 6 AM 3 PM PST (8 5 CST / 9 6 EST)
Position Type: Full-Time, Permanent
Industry: Healthcare Medical Economics
Salary Range: $87,000 $95,000/year
Bonus: 8% target
Sponsorship: Not available
Relocation: Not available

We are seeking a Data Analyst III Medical Economics to support analytics, reporting, and financial modeling within the Medical Economics and Managed Care teams. This role will focus on large healthcare datasets, claims analysis, and supporting cost, revenue, and MLR-related analytics. The ideal candidate will have strong SQL, Excel, and Power BI skills, combined with knowledge of Medicare, Medicaid, and Marketplace programs.

• Perform data extraction, validation, and analysis using large healthcare datasets.

• Develop and execute complex SQL queries and scripts to support reporting and analytical needs.

• Build and maintain dashboards, reports, and financial models using Excel and Power BI .

• Conduct analysis related to:

  • Medical Loss Ratio (MLR)

  • Quality and Affordability Initiatives (QAI)

  • Marketplace, Medicare, and Medicaid programs

  • Key performance indicators (KPIs)

• Apply knowledge of advanced payment methodologies including:

  • DRG pricing

  • APC

  • EAPG

• Collaborate with cross-functional teams including Finance, Actuarial, and Operations to evaluate performance metrics and support decision-making.

• Ensure accuracy, completeness, and consistency of data in all analyses and reports.

• Bachelor's degree in Business, Economics, Statistics, Mathematics, Actuarial Science, Public Health, Health Informatics, Healthcare Administration, Finance, or a related field.

  • Master's degree preferred

  • Without a bachelor's degree: 8+ years of experience required

• 4+ years of experience in:

  • Large database management

  • Data verification and validation

  • Medical economics or healthcare financial analytics
    OR
    2+ years of IT experience (data-focused roles)

• Experience with Medicare, Medicaid, and Marketplace analytics .

• Advanced SQL skills , including the ability to write complex queries and multiple JOIN types.

• Advanced Excel skills , including:

  • Pivot Tables

  • Power Query

  • VLOOKUP/XLOOKUP

  • Creating and nesting formulas

  • Financial modeling

• Power BI experience , including:

  • DAX

  • Power Pivot

• Strong understanding of healthcare payment methodologies (DRG, APC, EAPG).

• Experience with Python or R for data analysis or automation.

• Actuarial experience or exposure to actuarial modeling.

• Consulting experience in managed care or medical economics.

• This is a newly created position as part of the organization's growing Medical Economics team.

• Hiring managers have had strong success with candidates who have actuarial backgrounds or consulting experience in managed care.

• Maximum compensation is $95k base salary .

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