The Sr. Healthcare/Actuarial Analyst will be part of the Medical Economics and Analytics team responsible for all Medical Economic and performance analytics related to the quality and cost performance of Integra Connect oncology clients. This position will identify and design medical economic and analytics products (technology, reports, analyses, etc.) that optimize the performance measurement, improvement opportunities, and performance forecasting for all aspects of Integra Connect Precision Oncology operations, as well as specialty practice operations, using clinical data, administrative data, and paid claims data from third party payers. This role is critical for translating medical economics and clinical aspects of value-based care into business solutions.
Additional responsibilities include the design and analysis associated with creating, implementing, forecasting, and performance reporting related to a wide range of alternative payment models (APMs) and value-based contracts with third party payers. Supports sales, and other Integra Connect stakeholders with medical economics and analytical services.
- Designs, develops, and manages the medical economics and analytics services for Integra Connect Population Health clients with a focus on value-based care, precision oncology and alternative payment models; solution examples include Predictive Analytics using AI/Machine Learning, Cost, Utilization and Quality analysis, Clinical Practice Patterns and Care Path analysis based, HCC Coding analysis, Payer APM Risk Analysis, Provider Performance Benchmarking, Treatment Outcomes, and Comparative Effectiveness analysis
- Collaborates with cross-functional SME and engineering teams on the design, development and operation of technical platforms and tools to support Population Health and Precision Oncology analytics
- Work with Payer Contracting resources to support the development, implementation, and performance management of APMs and other value-based reimbursement contracts with third party payers.
- Translate medical economics and clinical aspects of value-based care into business solutions that drive financial results for the company.
- Provides consultative advice and direction to both clients and internal Integra Connect teams to meet both the short-term and long-term strategic goals of both organizations.
- Anticipates issues, analyzes existing operation, and seeks out new methodologies to improve efficiency and profitability.
- Maintain and update actuarial models and proactively identify solutions.
- 3-5 years of progressive Medical Economics and analytics experience within payers, providers, analytics firms and/or consulting firms supporting Population Health, ACOs, Oncology Medical Homes, Risk Contracting and/or Precision Oncology.
- Bachelor’s or Masters (preferred) degree in Actuarial Science, Math, Economics or related field Required; Master’s Degree and/or PHD Preferred.
- Hands-on experienced in using analytics tools, such as R, Python, SAS, AI/Machine Learning, SQL Queries
- Experience working with medical claims and payer risk contracting.
- Proven track record of translating medical economics and value-based care clinical aspects into actionable business solutions for clients and Integra Connect operations.
- Ability to travel up to 30% of the time (Post Covid-19).
- Ability to work in a dynamic, fast-paced environment.
Integra Connect, LLC provides a comprehensive benefits plan.
- Medical/Dental/Vision Insurance beginning the 1st of the month following your date of hire
- Paid Time Off
- 401k with employer match
- Paid Holidays and Floating Holiday
Equal Opportunity Employer
|Job Category||Analytics, Population Health|