A

AdventHealth

Integrated health system delivering whole-person care

Medical Economics Analyst 2

Data AnalysisPosted on Nov 13
Full-timeMaitland, FL, USA$66.8k - $124.3k

About the Job

Requirements

  • Managed care, patient financial services, health insurance claims processing, contract management, or medical economics experience or knowledge is required.
  • Proficiency in understanding professional and facility claims and managed care concepts such as risk adjustment, capitation, fee-for-service, diagnosis-related groups, ambulatory payment groups, ambulatory payment classifications, and other payment mechanisms is required.
  • Experience modeling the financial impact of changes is required.
  • Ability to handle multiple projects involving problem solving, research, analysis, and communication in a fast-paced environment is required.
  • Intermediate proficiency with Microsoft Excel, including formulas, calculations, charts, and graphs, is required.
  • Strong analytical and problem-solving skills and presentation skills are required.
  • A Bachelor's degree is required in Finance, Health Care Administration, Accounting, Mathematics, Health and Informatics, or a related field.

Responsibilities

  • Research and analyze managed care data from various financial systems and interface tools.
  • Perform complex healthcare data analysis, including financial modeling and risk forecasting.
  • Identify and implement improvements in quality control and reporting timeliness.
  • Extract, collect, analyze, and interpret health utilization and financial data.
  • Interpret and analyze data from various sources using knowledge of healthcare managed care contracts and administrative claims data.
  • Employ existing complex models and implement them on new projects and contexts.
  • Design new solutions for organizational data and analytics challenges.
  • Support negotiations of capitated and other value-based agreements through detailed data analytics.
  • Develop financial models to inform negotiation parameters.
  • Evaluate possible changes to key terms in existing value-based agreements.
  • Identify risk and exposure associated with various reimbursement structures.
  • Produce prospective analyses on new ventures, products, and service offerings.
  • Prepare and present analytics or project results to key stakeholders for review and decision-making.
  • Evaluate and understand contract language related to reimbursement methodologies for various provider types.
  • Apply detailed understanding of medical coding.
  • Perform other duties as assigned.

Desired Qualifications

  • 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.
  • A Master's degree in a related field is preferred.
  • Four or more years of experience performing data, financial, and/or risk analytics in a healthcare environment is preferred.
  • EPIC Hospital Billing certification is preferred.

About the Company

AdventHealth

Integrated health system delivering whole-person care

AdventHealth operates a nationwide network that provides whole-person health care across hospitals, physician practices, ambulatory surgery centers, outpatient clinics, home health, hospice, and digital tools. It coordinates care through an integrated system where care teams work across inpatient, outpatient, and at-home settings, supported by the AdventHealth app for scheduling, telehealth, and records. It differentiates itself with a mission-driven focus rooted in Christian heritage and a large, connected network designed to cover the full patient journey from hospital to home. Its goal is to extend the healing ministry of Christ by improving the health and prosperity of the communities it serves, offering accessible, coordinated care that addresses physical, mental, and spiritual well-being.

Company size
10,001+
Company stage
Grant
Total funding
$250K
Headquarters
Florida, United States
Founded
1973

Recently Posted Jobs

Explore more opportunities at AdventHealth

See more jobs