Medical Economics Sr Analyst

Accountabilities Lead the analysis and monitoring of healthcare utilisation using medical economics metrics, including per-member-per-month (PMPM) costs, utilisation per thousand members, prevalence, and service intensity.

Develop, maintain, and enhance reports covering healthcare utilisation, premiums, and pay-for-performance programmes.

Monitor monthly utilisation patterns, identify emerging trends, and prepare forecasts to support financial and operational planning.

Identify key healthcare cost drivers and collaborate with medical economics leadership to develop, prioritise, and implement cost-management initiatives.

Partner with business stakeholders to identify ad hoc reporting needs, define reporting requirements, and deliver relevant analytical insights.

Build and maintain financial models to evaluate the expected and actual financial impact of medical cost action plans.

Assess the financial implications of North Carolina state rate and policy changes affecting Medicaid Tailored Plans.

Collaborate with Utilization Management teams to analyse the cost impact of new healthcare services and changes to existing service definitions.

Use SQL, Microsoft Excel, and MicroStrategy to develop and maintain dashboards, reports, and data visualisations for business stakeholders.

Present analytical findings clearly and concisely, applying data visualisation best practices to support operational decisions and strategic planning.

Monitor healthcare industry developments, regulatory changes, and policy updates that may influence financial performance.

Collaborate with cross-functional teams, including Utilization Management and Provider Network, to develop evidence-based recommendations and actionable strategies.

Establish effective working relationships across departments, communicate technical concepts to non-technical audiences, and support the timely resolution of complex analytical challenges.

Requirements:

A bachelor's degree in Healthcare Management, Health Informatics, Economics, Statistics, Finance, or a related field.

At least 5 years of professional experience in finance, analytics, or a related discipline.

Strong knowledge of financial data analysis, statistical methodologies, and quantitative analysis; healthcare industry experience is preferred.

Expert-level proficiency in SQL and Microsoft Excel, with the ability to manipulate complex datasets, develop financial models, and produce accurate reports.

Experience developing dashboards, reports, and data visualisations using tools such as MicroStrategy or comparable business intelligence platforms.

Strong business acumen and the ability to connect analytical findings with financial outcomes, healthcare utilisation patterns, and operational priorities.

Excellent problem-solving skills, including the ability to evaluate alternative approaches and resolve complex analytical issues.

Strong written and verbal communication skills, with the ability to present detailed analytical findings in an accessible format for non-technical stakeholders.

Ability to work independently, manage competing priorities, establish objectives, and organise workflows effectively.

Strong collaboration and relationship-building skills, including the ability to obtain cross-functional cooperation and align diverse stakeholders around shared goals.

Sound judgement and decision-making skills, with the ability to assess complex matters and provide timely, well-supported recommendations.

High attention to detail and the ability to prepare concise, accurate reports, forecasts, and analytical plans.

Location requirement: Candidates must reside in North Carolina and be willing to travel to the Morrisville, North Carolina, office for onsite team meetings as needed.

Benefits:

Annual salary range: $69,592–$88,729, with final compensation determined by education, experience, external market data, and internal equity.

Healthcare coverage: Medical, dental, and vision insurance.

Financial protection: Life insurance and long-term disability coverage.

Retirement savings: A generous retirement savings plan.

Flexible working arrangements: Full-time remote work, with flexibility in scheduling and potential hybrid options where applicable.

Paid time off: Vacation, sick leave, holidays, and management leave.

Workplace flexibility: Flexible dress expectations.

Professional impact: The opportunity to contribute to healthcare financial analysis, cost-management initiatives, and data-driven operational improvements.

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