Medical Economist- Associate (705336)
Location
Harrisburg, PA | United States
Job description
Minimum Qualifications
- Possess Bachelor's Degree, and At least two (2) years of experience doing medical economic analyses
- A working knowledge of inpatient and outpatient medical industry operations or claims analysis to identify aberrant billing patterns
- High level proficiency in: SAS, SQL, data mining software and Microsoft Office Suite, including Access Excel, Power Point and Word
- Experience in accessing. using and analyzing complex medical information databases
- (A good working knowledge of Medicaid/Medical Assistance a plus, but not required)
Consultant will:
- Be available as a full time consultant approximately 37.5 hours per week.
- Analyze health care related data including, but not limited to, claim and encounter data for inpatient, outpatient, long term care, dental, pharmacy and professional services, beneficiary eligibility data, service provider data, managed care capitation payment data, the third-party liability coverage data, and managed care submitted data.
- Assist in fiscal and program analyses to support Medical Assistance Program decision-making processes.
- Assist in analyses to support medical assistance business operating decisions and for tracking, reporting and controlling of Medical Assistance costs.
- Assist in analyses to support the development of effective provider network management, reimbursement systems and strategies or identification of abuse or waste in the Medical Assistance program.
- Assist in cost benefit analyses for new Medical Assistance initiatives.
- Assist in Medical Assistance cost trend analyses by geography, services provider type, place of service and other factors to discover trends and suggest action plans.
- Assist in fiscal and impact analysis of potential cost containment initiatives.
- Using SAS, assist in developing processes to access data sources, extract data, apply requested parameters and perform analysis to provide information requested by OMAP management. The process generally includes multiple data sources and requires relational database analysis.
- Utilize Microsoft Office Suite products to present the results, analyses, and other deliverables for information requestors. These Microsoft Office Suite programs include, but not limited to, Word, Excel, Access, Power Point and Outlook.
- Provide high volume data files in appropriate formats such as delimited and fixed width text files.
- Generate process documentations in detail enough so that other users can replicate the process.
- Utilize other software including Business Objects and Cognos Report Studio as alternate resources to access data sources.
- Using SAS, assist in developing process automation by writing SAS codes, debugging, testing and documenting the process.
- Utilize other software as requested to analyze health care data.
- Participate in meetings and group discussion as a Subject Matter Expert in data issues and data processing systems.
About Us:
TulaRay partners with clients to create staffing solutions that meet unique organizational needs. Our services are designed to reduce administrative burdens, protect your brand, and improve assignment time-to-fill. We believe that mutually successful client relationships are built on lasting quality and exceptional customer service. We pride ourselves on our uncompromising commitment to high-quality emergency management & healthcare personnel, while ensuring that our clients are taken care of with personalized attention. TulaRay manages total compliance and respectfully supports hundreds of professionals and patient-centered programs.
TulaRay is proud to be an affirmative action employer and is committed to providing equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. If you have a disability or special need that requires accommodation, please let us know by visiting our website at tularay.com
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