WellBe Senior Medical
Senior Healthcare Economics Analyst
WellBe Senior Medical, Chicago, Illinois, United States, 60290
Senior Healthcare Economics Analyst
As a Healthcare Economics Analyst at
WellBe Senior Medical , you will play a pivotal role in shaping the organization’s healthcare strategy through advanced analytics and economic modeling. You will lead high-impact initiatives, provide strategic insights to senior leadership, and serve as a trusted advisor across departments.
Lead complex analyses of medical and pharmacy claims, enrollment, and provider data to uncover cost drivers and utilization trends.
Develop and implement innovative tools and methodologies to monitor healthcare trends and identify affordability opportunities.
Deliver actionable insights to support contract negotiations, care management programs, and network optimization strategies.
Build and maintain predictive models to assess the financial and clinical impact of strategic initiatives.
Design executive-level dashboards and reports to monitor performance and diagnose cost trend anomalies.
Partner with actuarial, clinical, data science, and business teams to forecast medical costs and evaluate risk adjustment performance.
Present findings and strategic recommendations to senior leadership using clear, compelling visualizations and narratives.
Conduct pro forma and sensitivity analyses to estimate the financial value of proposed cost containment initiatives.
Mentor and guide junior analysts, establishing best practices in data validation, analytical methods, and reporting standards.
Ensure all analyses adhere to regulatory requirements and industry best practices.
Champion a culture of collaboration, innovation, and continuous improvement across the analytics team.
Promote data governance, security, and compliance across all analytics workflows.
Strong sense of ownership, bias for action, and drive.
Strong verbal and written communication.
Excellent analytical and problem-solving skills.
Strong work ethic and attention to detail.
Advanced proficiency in SQL, Tableau, and Snowflake; experience with enterprise reporting tools.
Working knowledge of Python or R for statistical modeling and automation.
Deep understanding of CMS programs (Medicare Advantage, Medicaid) and HCC risk adjustment methodologies.
Experience with statistical modeling, forecasting, and predictive analytics.
Strong communication skills with the ability to translate complex data into strategic insights for non-technical audiences.
Proven ability to lead cross-functional projects and influence decision-making at the executive level.
High level of ownership, initiative, and attention to detail.
Qualifications
Bachelor’s degree in Economics, Mathematics, Statistics, Public Health, Health Administration, or related field (Master’s preferred).
5-7 years of progressive experience in healthcare analytics, medical economics, actuarial analysis, or health plan finance.
Extensive experience working with medical and pharmacy claims, risk adjustment, and value-based care data.
Strong understanding of healthcare reimbursement models (FFS, capitation, shared savings, risk contracts).
Experience with cloud-based data platforms (Snowflake or similar).
Demonstrated ability to lead and mentor teams, and drive strategic initiatives.
Excellent problem-solving, interpersonal, and stakeholder management skills.
Travel Requirements Travel may be required up to 15% locally or nationally.
Work Conditions Ability to lift up to 20lbs. Moving, lifting, or transferring of patients may involve lifting up to 50lbs as well as assisting with weights of more than 50lbs.
Ability to stand for extended periods.
Ability to drive to patient locations (ie. home, hospital, SNF, etc).
Fine motor skills.
Visual acuity.
The preceding functions may not be comprehensive in scope regarding work performed by an employee assigned to this position classification. Management reserves the right to add, modify, change or rescind the work assignments of this position. Management also reserves the right to make reasonable accommodations for a qualified employee(s) to perform the essential functions of this role.
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WellBe Senior Medical , you will play a pivotal role in shaping the organization’s healthcare strategy through advanced analytics and economic modeling. You will lead high-impact initiatives, provide strategic insights to senior leadership, and serve as a trusted advisor across departments.
Lead complex analyses of medical and pharmacy claims, enrollment, and provider data to uncover cost drivers and utilization trends.
Develop and implement innovative tools and methodologies to monitor healthcare trends and identify affordability opportunities.
Deliver actionable insights to support contract negotiations, care management programs, and network optimization strategies.
Build and maintain predictive models to assess the financial and clinical impact of strategic initiatives.
Design executive-level dashboards and reports to monitor performance and diagnose cost trend anomalies.
Partner with actuarial, clinical, data science, and business teams to forecast medical costs and evaluate risk adjustment performance.
Present findings and strategic recommendations to senior leadership using clear, compelling visualizations and narratives.
Conduct pro forma and sensitivity analyses to estimate the financial value of proposed cost containment initiatives.
Mentor and guide junior analysts, establishing best practices in data validation, analytical methods, and reporting standards.
Ensure all analyses adhere to regulatory requirements and industry best practices.
Champion a culture of collaboration, innovation, and continuous improvement across the analytics team.
Promote data governance, security, and compliance across all analytics workflows.
Strong sense of ownership, bias for action, and drive.
Strong verbal and written communication.
Excellent analytical and problem-solving skills.
Strong work ethic and attention to detail.
Advanced proficiency in SQL, Tableau, and Snowflake; experience with enterprise reporting tools.
Working knowledge of Python or R for statistical modeling and automation.
Deep understanding of CMS programs (Medicare Advantage, Medicaid) and HCC risk adjustment methodologies.
Experience with statistical modeling, forecasting, and predictive analytics.
Strong communication skills with the ability to translate complex data into strategic insights for non-technical audiences.
Proven ability to lead cross-functional projects and influence decision-making at the executive level.
High level of ownership, initiative, and attention to detail.
Qualifications
Bachelor’s degree in Economics, Mathematics, Statistics, Public Health, Health Administration, or related field (Master’s preferred).
5-7 years of progressive experience in healthcare analytics, medical economics, actuarial analysis, or health plan finance.
Extensive experience working with medical and pharmacy claims, risk adjustment, and value-based care data.
Strong understanding of healthcare reimbursement models (FFS, capitation, shared savings, risk contracts).
Experience with cloud-based data platforms (Snowflake or similar).
Demonstrated ability to lead and mentor teams, and drive strategic initiatives.
Excellent problem-solving, interpersonal, and stakeholder management skills.
Travel Requirements Travel may be required up to 15% locally or nationally.
Work Conditions Ability to lift up to 20lbs. Moving, lifting, or transferring of patients may involve lifting up to 50lbs as well as assisting with weights of more than 50lbs.
Ability to stand for extended periods.
Ability to drive to patient locations (ie. home, hospital, SNF, etc).
Fine motor skills.
Visual acuity.
The preceding functions may not be comprehensive in scope regarding work performed by an employee assigned to this position classification. Management reserves the right to add, modify, change or rescind the work assignments of this position. Management also reserves the right to make reasonable accommodations for a qualified employee(s) to perform the essential functions of this role.
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