Healthcare Economics Analyst

Who We Are:

TurningPoint Healthcare Solutions is a leader in advanced clinical and technology-enabled complex condition management. TurningPoint provides an innovative suite of specialty care management services and technologies that enable health plans and employers to improve the safety, quality, and affordability of healthcare. Through its platform and specialized team of clinical experts, TurningPoint works collaboratively with providers to deliver optimal care. TurningPoint offers condition-specific, quality-driven, value-based care management services that optimize care from diagnosis and discovery through recovery. TurningPoint’s comprehensive and integrated suite of services enhances the support individuals need, at the time they need it most. Since launching in 2015, TurningPoint has provided support to more than 50 million people nationwide across numerous clinical specialties including musculoskeletal, pain management, cardiology, wound care, ear/nose/throat, and sleep. TurningPoint’s model moves beyond denial-based care to holistic condition management that improves outcomes and reduces cost. TurningPoint is an independent organization, not owned or affiliated with a health plan or provider system.

Position Summary:

The Healthcare Economics Analyst provides support and consultation to the Health Economics team through analyzing key business issues related to cost, utilization and revenue for all risk clients. Designs and develops reports to monitor health plan performance and identify the root causes of medical cost trends. Drives innovation by creating tools to monitor trend drivers and provide recommendations for affordability opportunities.

Roles and Responsibilities:

• Perform drilldown analysis into claims trend to identify actionable items focusing on cost and utilization measures
• Support Financial Analysis projects related to medical and provider cost reduction initiatives.
• Lead and manage data validation opportunities with the internal and external client to identify and solve issues
• Ad hoc analytics and reporting duties to meet the needs of company resources and external customers
• Other duties as assigned
  
  
  

Education, Experience and Licensure:

• Knowledge of healthcare data (claims, medical coding, providers, member eligibility, value based reimbursement etc.) to analyze opportunities and solve issues
• Understanding and working experience in SQL databases and coding
• Understanding and working experience with Power BI and/or Tableau
• General understanding of ETL process to support data engineering partners with quality reviews and data integrity validation
• Effective communication skills, both orally and in writing using language understandable to management and employees
• Demonstrated ability to understand complex healthcare financial, clinical, and operational issues
• Ability to think creatively to find solutions
• Precise attention to detail
• Bachelor’s Degree in Healthcare Analytics, Computer Science, Math/Statistics, or related fields
• Experience as a business/ data analyst, or any other health insurance/ healthcare related environment.
  
  
  

Preferred Skills:

• Customer Focus, Customer Service, Verbal Communication, Informing Others, Process Improvement, Problem Solving, People Skills, Teamwork, People Management, Managing Processes, Emphasizing Excellence.
• Strong organizational skills, excellent analytical skills, commitment to customer service; ability to problem solve; strong presentation skills throughout all levels of the organization.
• Proficient in Microsoft Office Suite software (Word, Excel, PowerPoint, Visio, Outlook, etc.).
• Proficient in Microsoft SQL Server 2008/2012/latest and database concepts/coding
  
  
  

TurningPoint Healthcare Solutions is an Equal Opportunity Employer