Senior Health Economist - Managed Care

Senior Health Economist - Managed Care

Senior Health Economist - Managed Care

Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Carelon Health is a proud member of the Elevance Health family of brands, offering clinical programs and primary care options for seniors. We are a team of committed clinicians and business leaders passionate about transforming American healthcare delivery.

The Senior Health Economist (Advanced Analytics Analyst Senior) measures financial performance of core Carelon products leveraging claims, authorization, and membership data to tell a detailed story to respective business stakeholders. The Senior Health Economist creates statistical models to predict, classify, quantify, and/or forecast business metrics. Design modeling studies to address specific business issues determined by consultation with business partners.

How you will make an impact:

• Prepares analytical data sets in support of modeling studies. Build, test, and validate statistical models.
• Publishes results and addresses constraints/limitations with high-level business partners.
• Proactively collaborates with business partners to determine identified population segments.
• Develop actionable plans to enable the identification of patterns related to quality, use, cost, and other variables.

Minimum Requirements:

• Requires MS, MA, or PhD with concentration in a quantitative discipline such as statistics, computer science, cognitive science, economics, or operations research, a minimum of 3 years direct experience programming large, multi-source datasets with SAS required, and a minimum of 3 years in health care setting; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences:

• Actuarial sciences background highly preferred.
• Utilization Management experience preferred.
• Medical economics, provider finance, healthcare analytics, and/or financial services highly preferred.
• Comprehensive understanding of medical claims data.
• Intermediate to Advanced expertise with SQL, SQL Server, Teradata, or equivalent strongly preferred.
• Proven ability to design modeling studies and experience with data models, addressing data quality issues in study design, and constructing robust and efficient analytical data sets strongly preferred.
• Significant experience in a healthcare-related field strongly preferred.
• The ability to present meaningful results to a business audience, to participate collaboratively in a team tasked to produce complex analyses on a rigorous schedule, to communicate with strong written and verbal communication skills, and to present to large multi-disciplinary audiences regularly strongly preferred.

Job Level: Non-Management Exempt

Workshift: 1st Shift (United States of America)

Job Family: RDA > Reporting & Data Analysis