Humana Medical Economics Consultant in Tampa, Florida
Role: Medical Economics Consultant
Assignment: Medical Economics
Location: Tampa or Doral, FL
Assignment Capsule Seeking an individual to support network management and affect unit-cost trends. In this role, the team member will be responsible for the following:
· Capitation Management: Review pricing for new and existing physician and ancillary capitation arrangements to deliver optimal value to Care Plus.
· Hospital Pricing: Develop pricing models and conduct contract reviews to support contract negotiations and measure contract performance.
· Support Medical Economics initiatives around efficiency, data validation, automation, and next-generation analytics.
· Bachelor’s degree in Finance or related field
· Five (5) years work experience in healthcare analytics/data modeling
· Strong analytical and critical thinking skills
· Advanced level experience with Microsoft Excel and Access
· Intermediate in PowerPoint
· Experience summarizing data and creating executive summaries with analysis
· Ability to handle multiple tasks and deadlines with attention to detail
· Excellent communication skills
· Operational understanding of provider networks and capitation agreements
· Experience with Microsoft SQL reporting and relational databases
· Experience with pricing specialty care and ancillary lines
· Claim processing and audit experience
· Medical coding experience
Reporting Relationships You will report to the Manager of Medical Economics. This area is under the leadership of the Director of Finance.
Humana is an organization with careers that change lives—including yours. As an innovator in the fast-paced industry of healthcare, we offer our associates careers that challenge, support and inspire them to use their passion for helping others and to lead their best lives. If you’re ready to help people achieve lifelong well-being, and be a part of an organization that is growing and poised to make an impact on the future of healthcare, Humana has the right opportunity for you.
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Montage Voice to enhance our hiring and decision-making ability. Montage Voice allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
If you are selected for a first round interview, you will receive an email correspondence(please be sure to check your spam or junk folders often to ensure communication isn’t missed)inviting you to participate in a Montage Voice interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Please be advised, the role opportunity displayed here is for CarePlus - a wholly owned subsidiary of Humana Inc.
Title: Medical Economics Consultant
Other Locations: US-FL-Doral
Requisition ID: 178107