About Fallon Health:
Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit www.fallonhealth.org.
The Medical Economics Consultant will partner with the Vice President, Medical Economics and Line of Business owner as a subject matter expert in data and analysis, demonstrating an in-depth understanding of financial, clinical, and other business data. This position will extract, analyze and interpret Healthcare data to uncover trends and assist in managing and understanding the Line of Business medical cost. The Medical Economics Consultant demonstrates business intelligence, being able to apply analyses to both financial as well as clinical operations in a meaningful manner. The position works directly with operational leadership in the design and development of analytical capabilities, reports, and dashboards needed for short and long-term decision-making as it pertains to a specific line of business. This individual provides complex ad hoc analysis and reporting as directed by management to include the evaluation of financial, operational, clinical and general business programs and processes. The Medical Economics Consultant is responsible for data quality and data integrity as they relate to reporting and analysis activities. This position provides data in support of Actuarial, Financial, and Utilization analyses, as it relates to medical cost improvements and alternative pricing strategies.
Primary Job Responsibilities:
Analysis, Decision Support, and Business Intelligence – 60%
Financial and Clinical Model Design and Support – 30%
Ad Hoc Support – 10%
Bachelor’s degree in Business, Finance or Public Health
Minimum of 7 years clinical analytical experience in healthcare environment