Duration: Long term Contract
Position Summary
The Executive Medical Economist will analyze healthcare data to identify fraud, abuse, and billing irregularities. This role is responsible for performing advanced medical cost analyses, developing data collection and reporting processes, and collaborating with clinical, executive, and technical stakeholders to support data-driven decision-making and program integrity initiatives.
Education & Experience
- Master's degree in a relevant field or
- Extensive medical analysis experience exceeding the minimum qualifications.
Key Responsibilities
- Access, retrieve, and analyze healthcare data to identify aberrant billing practices.
- Prepare data queries to detect fraud and abuse in medical claims.
- Summarize and analyze data for management reporting.
- Design and maintain computerized data collection and reporting processes.
- Conduct detailed medical cost analyses to support cost-effective and clinically sound programs.
- Recommend medical cost containment strategies based on analytical findings.
- Collaborate with cross-functional teams to improve analytical efforts.
- Partner with physicians, nurses, executives, and data specialists to understand business and analytical requirements.
- Analyze cost trends by geography, provider, service type, place of service, and other relevant factors, and provide actionable recommendations.
- Utilize Microsoft Office applications, data mining tools, and data warehouse technologies to support reporting and analysis.
Required Qualifications
- Master's degree or equivalent advanced experience in medical analysis.
- Experience detecting healthcare fraud and abuse.
- Proficiency with word processing software.
- Strong spreadsheet skills (e.g., Microsoft Excel).
- Experience working with desktop databases.
- Experience with data extraction and data analysis.
- Understanding of data summarization concepts.
- Excellent analytical, interpersonal, and communication skills.
Technical Skills
- Microsoft Office Suite
- Data Analysis
- Data Extraction
- Data Mining
- Data Warehousing
- Database Management
- Healthcare Claims Analysis
- Reporting & Analytics
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About our Company: -
22nd Century Technologies, Inc., is one of the fastest growing IT Service Integrator and Workforce Solution companies in the United States. Founded in 1997, 22nd Century Technologies is a Certified National Minority Business Enterprise with 6,000+ people including 600+ Cyber SMEs nationwide supporting our customers in all 50 states, Canada, and Mexico. With HQs in Somerset, NJ and Mclean, VA, 22nd Century has 14 offices throughout the United States. As part of our unrelenting focus on quality and compliance, 22nd Century Technologies’ delivery is based on Certified Matured Processes including CMMI L3 Dev & SVC, ISO 20000, ISO 27001, and ISO 9001 quality processes. With a strong focus on the public sector, 22nd Century currently holds government contracts with 14 out of 15 Federal Executive agencies including DoD, 37 other Federal agencies, 50 States, 115+ Local agencies, and 37 School Districts. In the last three years, we have expanded our services to Fortune 500 and other commercial clients and currently support 80+ commercial clients.
Recognized among “Best Company to Work For” by Forbes, 22nd Century Technologies, Inc., consistently exceeds our clients’ expectations by focusing on their absolute satisfaction with jobs while keeping our employees motivated.
“22nd Century Technologies is an Equal Opportunity Employer" and “US Citizens & all other parties authorized to work in the US are encouraged to apply."
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
Pay: $40.00 - $50.00 per hour
Benefits:
Education:
Experience:
- Healthcare data analysis: 5 years (Required)
- SQL and data extraction: 5 years (Required)
Ability to Commute:
- Harrisburg, PA 17120 (Required)
Work Location: In person
