Company Statement

Connecticare is a leading health plan in the state of Connecticut and a subsidiary of EmblemHealth, a health and wellness company that provides insurance plans, primary and specialty care, and wellness solutions.  WellSpark is a digital wellness company and national subsidiary of EmblemHealth that offers a full suite of products and solutions to reward people for healthy behaviors.

 

To protect the health and safety of our workforce, members, patients, and the communities we serve, the EmblemHealth family of companies require all new employees to be fully vaccinated for COVID-19. Exemption/reasonable accommodations may be granted because of 1) a qualifying medical condition or disability that makes getting the vaccine unsafe for the individual, or 2) objection on the basis of sincerely held religious beliefs and/or practices.
 

Medical Economics Analyst

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Manager & Professional
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EmblemHealth
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  • Will extract, analyze and interpret data to produce both standard claims and utilization trend reporting and ad hoc analysis requests.
  • Supports all functions within Medical Economics including monitoring of specific corporate and health cost containment initiatives.

Responsibilities:

  • Supports research and analysis of financial data, draws conclusions and provides consultation to internal and external partners for use in administering specific programs and processes related to medical expense and utilization.
  • May create comparative views of unit cost information that contracting teams can utilize to identify outlier contracts. 
  • Conducts ongoing monitoring of medical cost savings initiatives.
  • Assist the business units to identify trend outliers, analyze the trend drivers and perform the work necessary to facilitate the discussion on possible solutions.
  • Performs detailed analyses, including accumulation of data, financial modeling, and reporting of outcomes.
  • May provides detailed analytics to provider network contracting teams in support of the negotiation process.
  • Develops ad hoc views of data that illustrates underlying trend issues for both cost and utilization.
  • Performs additional duties as assigned. 

Requirements:

  • BA/BS in Mathematics, Economics, Healthcare or other quantitative discipline required
  • 3-5 years of related work experience, preferably in a healthcare provider or insurance environment required
  • Related internship experience/graduate level education and/or specialized skills/training, may be considered as counting toward experience requirements required
  • Strong knowledge of and experience working with healthcare data including but not limited to claims, testing results and pharmacy data required
  • High proficiency with MS Office (Word, Excel, PowerPoint) with emphasis with Excel required
  • Preparing dashboards and preparing and presenting data using a data visualization tool such as Tableau preferred
  • Strong data querying skills using tools such as SQL or SAS Enterprise Guide preferred

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