Sr. Medical Economic Analyst
Roanoke, VA - USA
Job Summary
Onsite is preferred hybrid or remote work option is available. Candidates residing in the following states can be considered for remote work: Alabama Florida Georgia Arkansas Kentucky Louisiana Mississippi North Carolina South Carolina Tennessee West Virginia and Virginia.
- Leads modeling of commercial and government payment methodologies for all types of healthcare services: hospital physician ambulatory home health hospice etc.
- Transforms data into analytical insights to inform decisions for the Contracting team and Carilion executive stakeholders.
- Effectively communicates analysis to be consumed by department and executive leadership.
- Demonstrates expert knowledge of both commercial and governmental payers for modeling and analyzing contract proposals with a variety of reimbursement methodologies: case rates DRG fee schedules stoploss and other contract terms.
- Leverages hospital (FinThrive) and physician (Experian MPV) claim modeling systems for enhanced payer contract analytics.
- Continuously learns and adapts to a constantly changing reimbursement environment.
- Completes extensive and complex financial and operational analyses modeling of managed care contracts and proposals analyze fee schedules and determine contract performance and compliance.
- Extracts analyzes and synthesizes data from various sources to identify risks and opportunities.
Education: Bachelors degree in computer science accounting business data science statistics or related field. 4 years of relevant experience may be considered in lieu of degree.
Experience: Minimum 4 years of complex data analysis and data manipulation experience.
Licensure Certification and/or Registration: Specific certification(s) may be required as determined by the department. Life Support: N/A
Other Minimum Qualifications: High proficiency with computers operating systems relational databases and analytical and statistical software. Demonstrated skills in research design statistical analysis and statistical process control methodology. Strong analytical reasoning problem-solving capability written and verbal communication skills. Ability to manage competing deadlines prioritize tasks and maintain accuracy while working with large volumes of data. Ability to handle confidential and sensitive information with discretion; occasional travel may be required.
This job description is intended to be a representative summary of the major responsibilities and accountabilities performed by incumbents in this role. Incumbents may be required to perform job-related tasks other than those specifically presented in this description.
Compensation Range:
$76689.60 - $115044.80Employee pay is based on a variety of factors including qualifications credentials education and prior work experience. The compensation range does not include benefits or pension plan.
Recruiter:
MARK MISKOVICRecruiter Email:
For more information contact the HR Service Center at 1-.
Carilion Clinic is an Equal Opportunity Employer: We provide equal employment opportunities to all employees and applicants without regard to race color religion sex national origin age (40 or older) disability genetic information or veterans status. Carilion is a Drug-Free Workplace. For more information or for individuals with disabilities needing special assistance with our online application process contact Carilion HR Service Center at 8:00 a.m. to 4:30 p.m. Monday through Friday.
Required Experience:
Senior IC
About Company
Carilion Clinic is the largest not-for-profit integrated health system in western Virginia, the Shenandoah Valley, and surrounding regions, serving 1 million people. Carilion Clinic includes seven hospitals, 240+ practice locations, and 29 GME programs with 800+ physicians in over 78+ ... View more