Fort Wayne, Indiana
Lebanon, Pennsylvania
Brockton, Massachusetts
Posted: 01-Jun-25
Location: Maitland, Florida
Categories:
Internal Number: 25015949
All the benefits and perks you need for you and your family
· Benefits from Day One
· Career Development
· Whole Person Wellbeing Resources
· Mental Health Resources and Support
Our promise to you:
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Job Location: Monday-Friday Hybrid, Maitland FL
The role you’ll contribute:
A Medical Economics Analyst is responsible for supporting the Senior Medical Economics Analyst by applying technical, analytical, and problem-solving skills to provide solutions/improvements within the department. The role focuses on financial trends, reimbursement methodology, data tools, modeling, and managing revenue. Must be able to complete financial and operational analyses of managed care contracts, proposals, analyze fee schedules, and determine contract compliance. The Medical Economics analyst must have attention to detail and competencies in decision support and reporting through converting raw data as well as for creating meaningful applications to support executive decision making. Character traits to include: Strong work ethic, trainability, communicative, and team player The Medical Economics Analyst will work with Senior Medical Economics Analyst for both the Florida and Multi-State Divisions of AdventHealth, as well as represent AdventHealth managed care to payers in all AdventHealth Markets.
The value you’ll bring to the team:
- Assisting in Research and analyzes managed care data from the various financial systems and interface tools
- Assisting in analysis of complex and varied healthcare data including financial modeling and risk forecasting
- Work to identify/implement improvements in quality control/timeliness of reporting
- Works with Senior Medical Economics Analyst to extract, collect, analyze and interpret health utilization and financial data of various types
- Assists in interpreting analyzed data from various sources using knowledge of healthcare managed care contracts and healthcare administrative claims data
- Works alongside Senior Medical Economics Analyst in identify risk/exposure associated with various reimbursement structures. Produce prospective analyses an new venture, products, and service offerings
- Assists in performing analysis of complex and varied healthcare data including financial modeling
- Evaluate and understand contract language as it relates to reimbursement methodologies
- Demonstrates proficiency with various reimbursement methodologies including Per Diem, DRG, fee schedules, and percent of charge
- Assisting in ad-hoc reporting, management and intelligence related to large claimants, sequestration and healthcare exchange programs
- Accumulates data in logical format, interprets results and sends to Senior Medical Economic Analyst for review
- Prepares well-organized project-specific documentation, that includes at a minimum, analytic methods used with sufficient detail to support comprehension and replication
- Assists in the development of the annual Managed care net revenue budgets to support the annual AdventHealth Budget process for Florida and Multi-State Divisions
- Assists in evaluating actual contract performance against expected; analyzes data to distinguish patterns and recognize trends in contract performance
- Demonstrates independent thinking and creativity in development of contract models, standard reports and ad hoc analyses
- Assists in multiple projects in a fast-paced environment within timeframes outlined in the department policies and as specified by leadership
- Maintains a high degree of accuracy while using large amounts of data
- Participates in special projects and performs other duties as assigned
The expertise and experiences you’ll need to succeed:
Qualifications
- Bachelor's in Finance, Health Care Administration, Accounting, Mathematics, or Health and Informatics or related field Preferred
- 2 Related Experience Required
- Working knowledge of value-based arrangements, including shared savings, bundled payments, pay-for-performance, and capitation,
- Working knowledge of population health, utilization measurement, and claims analytics
- Managed Care, Patient Financial services, health insurance claims processing, contract management, or medical economics
- Proficiency in understanding professional and facility claims and managed care concepts such as risk adjustment, capitation, FFS, DRG, APG, APCs and other payment mechanisms
- Strong ability to handle multiple projects including problem solving, research, analysis, and communication in a fast-paced environment
- Beginner/Intermediate level of proficiency working with MS Excel including Formulas, calculations, charts, and graphs
Our people are passionate about what they do, the product they sell, and the customers they serve. If you're looking for an opportunity to be a part of a work family that values collaboration, innovation and dedication, we're the right company for you.
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.