Medical Economist- Associate - 649810
Allied Health | Harrisburg, PA | Full Time and Contract
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.
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)
Assist in the design and conduct of:
Fiscal and program analyses to support Pennsylvania Medical Assistance Program decision-making processes.
Analyses to support medical assistance business operating decisions and for tracking, reporting and controlling of Medical Assistance costs.
Analyses to support the development of effective provider network management and reimbursement strategies or identification of abuse or waste in the Medical Assistance program.
Cost benefit analyses for new Medical Assistance initiatives
Medical Assistance cost trend analyses by geography, services provider type, place of service and other factors to discover trends and suggest action plans.
Fiscal and impact analysis of potential cost containment initiatives.
Large data set analyses to determine whether targeted cost savings were achieved or to identify future savings targets
Analyses of various data sets to recommend payment levels and provide fiscal impact estimates
Development and maintenance of healthcare payment reconciliation systems
Participate in meetings to advise Commonwealth staff on work results.
Prepare summary level papers and defend analyses completed.
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