Amarillo, Texas
Indianapolis, Indiana
Nashville, Tennessee
Posted: 02-Nov-25
Location: Maitland, Florida
Categories:
Internal Number: 25033829
All the benefits and perks you need for you and your family:
Benefits from Day One
Career Development
Whole Person Wellbeing Resources
Mental Health Resources and Support
Our promise to you:
Joining AdventHealth is about being part of something bigger. Its about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Shift : Monday- Friday Full time 8am-5pm
Job Location : Maitland, FL hybrid (Monday, Wednesday, Thursday) on-site
The role you will contribute:
A Senior Medical Economics analyst is responsible for analyzing and evaluating financial and economic data related to healthcare costs and managed care payer rates and reimbursement. The role focuses on financial trends, reimbursement methodology, data tools, modeling, and managing revenue. Must be able to complete extensive and complex financial and operational analyses of managed care contracts and proposals, analyze fee schedules, and determine contract compliance. The Senior Medical Economics analyst must have attention to detail and competencies in decision support and reporting through converting raw data into meaningful applications to support executive decision making. Character traits to include: Strong work ethic, trainability, communicative, team player, and strong analytical skills The Senior Medical Economics Analyst will work with managed care staff for both in the Florida and Multi-State Divisions of AdventHealth, as well as represent AdventhHealth managed care to payers in all AdventHealth Markets.
The value you will bring to the team:
- Researches and analyzes managed care data from various financial systems and interface tools.
- Performs complex and varied healthcare data analysis, including financial modeling and risk forecasting.
- Identifies and implements improvements in quality control and timeliness of reporting.
- Extracts, collects, analyzes, and interprets health utilization and financial data.
- Interprets and analyzes data from various sources using knowledge of healthcare managed care contracts and administrative claims data.
- Employs existing complex models and implements them on new projects and contexts.
- Designs new solutions for data and analytic challenges faced by the organization.
- Supports negotiations of capitated and other value-based agreements through detailed data analytics.
- Develops financial models to inform negotiation parameters.
- Evaluates possible changes to key terms in existing value-based agreements.
- Identifies risk and exposure associated with various reimbursement structures.
- Produces prospective analyses on new ventures, products, and service offerings.
- Prepares and presents analytics or project results to key stakeholders for review and decision-making.
- Evaluates and understands contract language related to reimbursement methodologies for various provider types.
- Applies detailed understanding of medical coding.
- Other duties as assigned.
The expertise and experiences you'll need to succeed:
Bachelor's
Working knowledge of value-based arrangements, including shared savings, bundled payments, pay-for-performance, and capitation
Working knowledge of population health, utilization measurement, and claims analytics
Managed Care, Patient Financial services, health insurance claims processing, contract management, or medical economics
Proficiency in understanding professional and facility claims and managed care concepts such as risk adjustment, capitation, FFS, DRG, APG, APCs and other payment mechanisms
Experience in modeling financial impact of changes
Strong ability to handle multiple projects including problem solving, research, analysis, and communication in a fast-paced environment
Intermediate level of proficiency working with MS Excel including Formulas, calculations, charts, and graphs
Strong skills in analytical/problem solving and presentations
Preferred Qualifications:
Master's
4 Work ExperienceEPIC-Hospital Billing Certification (EPIC HB) Epic HB Certification
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.
Category: Managed Care
Organization: AdventHealth Corporate
Schedule: Full-time
Shift: 1 - Day
Req ID: 25033829
We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.
