Manager, Medical Economics

 
Title: Manager, Medical Economics  

Department: Decision Support Services  

About the role:  

We are looking for a full-time Manager, Medical Economics to join our fast-growing team. This is a team with exceptionally high visibility; you will be a core member of a team that uses data and analysis to steer Astrana Health’s growth via provider & payer contract negotiations. We have a startup-like mentality & career trajectory in a recently IPO’d, rapidly growing company. This role would report to our Director, Medical Economics.  

What you’ll do:   

• Mine data to discover key analytical insights for decision support, with a focus on evaluating & improving financial and operational performance on our health plan and institutional contracts 
• Build deal models for institutional, health plan, and provider contract negotiations, including Medicare Advantage, Commercial Risk, Medi-Cal, and Fee-for-Service 
• Identify cost-of-care savings opportunities by analyzing physician authorizing/billing patterns in relation to hospital admissions, emergency room visits, office visits, referral practices, and specialty care procedures and provide suggestions for vendor contract changes that can result in cost savings 

• Use data tools (e.g. SQL, Excel) for tracking, analyzing, forecasting and reporting on payors & hospitals’ financial impact 
• Identify, develop, and document audit findings to present to key stakeholders 
• Help develop proprietary analytics infrastructure, including various reports and dashboards, supporting our institutional and payor financial performance 
• Maintain and improve existing reporting infrastructure to support a variety of internal stakeholders from other teams 
• Mentor and manage a robust team of analysts 
• Complete a variety of strategic adhoc projects as assigned 

Qualifications:   

• Bachelor's degree in quantitative field such as finance, statistics, economics, math or engineering is preferred; Master’s degree (MBA, MHA, MPH) is preferred 
• Minimum 6 years of experience full-time in managed care or healthcare data analytics field; Health Plan or Provider Group experience preferred 
• Prior experience in an analytical/reporting role developing financial and operational models 

• Working knowledge of healthcare pricing and reimbursement methodologies for Medicare, Medicaid/Medi-Cal (CPT/HCPCS, DRG, etc.) 
• Basic understanding of healthcare policy trends (e.g. value based care) 
• Prior experience in project management and/or process improvement (current state analysis) (Preferred) 
• Proficiency in Excel (e.g. pivot tables, data manipulation), PowerPoint, and Word required 
• Proficiency with SQL or similar relational databases is required 
• Ability to process and analyze data to tell an accurate story via data visualizations, dashboards, and reports 
• Strong problem-solving, troubleshooting, and analytical skills with demonstrated ability to develop new reporting and insights using complex data environments 
• Strong oral and written communication; ability to communicate effectively across various levels & functions within the organization 

You’re great for this role if:   

• Comfortable with ambiguity and biased towards action. You can identify the 20% of the work that leads to 80% of the result and mobilize and execute the high-impact work consistently. You enjoy thinking about complex and ambiguous problems and can execute consistently and add compounding value. 
• Relentlessly resourceful. You enjoy taking ownership and can motivate others to get things done. You can work in a cross-functional environment and figure out the answer even when it’s not immediately obvious. You are resilient, detail-oriented, and truly believe that no task is beneath you, even in the face of potential challenges. 
• Growth-oriented. You can evaluate all perspectives, even if uncomfortable, and have the courage to adjust your views if necessary. You have the expertise and communication skills to look at challenges from a bird-eye view and determine the necessary steps to execute. 
• Mission-driven. You are excited by the prospect of diving into complex problems that will drastically improve patient outcomes, while lowering the cost of a tremendously inefficient US healthcare system, where waste is over 40% and per-capita healthcare dollars spent is double that of other developed nations. 

Why Astrana Health?   

Astrana Health (NASDAQ: ASTH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise in order to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient.   

With over a million managed lives across the country and terabytes of data generated, our software and applications need to be cutting-edge, efficient, and aligned with our core values of improving patient outcomes and empowering our providers.   

Our Values:  

• Put Patients First
• Empower Entrepreneurial Provider and Care Teams
• Operate with Integrity and Excellence
• Be Innovative
• Work as One Team

Environmental Job Requirements and Working Conditions:  

• This position is Remote and can be located anywhere in the United States
• The total compensation target pay range for this role is: $120,000 to $140,000. The salary range represents our national target range for this role.

Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.  

Additional Information:  

The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.