Business Analytics Advisor - Healthcare Economics - EviCore
Core
Oversee and assist in the design, development, analysis, and reporting of claims data using business intelligence tools and statistical techniques to understand healthcare trends, report program results, and identify opportunities to support sales and product growth.
Role type
Business Analytics Advisor (Healthcare Economics)
Builds
Claims data analysis deliverables, savings forecasts, pricing models, and strategic reports for internal stakeholders and customers.
Domain
Healthcare Economics / Managed Care / Insurance
Deliverable
dashboards & analysis
Required skills
Actuarial concepts, claims data analysis, baseline and trend analysis, SQL database manipulation, managed care metrics (PMPM, Utilization/K, Average Cost), IBNR calculations, provider network overlap analysis, fee schedule pricing, trend mitigation, population mix-shift analysis.
Preferred skills
Master's degree in finance/economics/statistics, experience in ACO/IPA/MCO settings, bundled payments experience, big data and data warehouse knowledge.
Responsibilities
Conduct baseline and trend analyses for targeted medical cost categories, geographies, and segments; Calculate baseline and trend metrics; Apply actuarial concepts to enhance understanding of utilization and cost trends; Validate findings against established benchmarks; Use baseline metrics to establish Savings Forecast and Pricing; Create and deliver accurate and timely results to internal and external customers; Communicate results to key stakeholders and policy makers through clean and well-organized presentations; Provide additional analyses supporting New Sales and Product Development.
Seniority
Mid-Senior level (8+ years experience)