This role is vital for cost containment and improving plan performance. Analyze complex medical claims, pharmacy data, and other healthcare data sets to identify emerging cost and utilization trends ...
This role is vital for cost containment and improving plan performance. Analyze complex medical claims, pharmacy data, and other healthcare data sets to identify emerging cost and utilization trends ...
Health Plan Data Scientist
Long Beach, CA · On-site
Apply data science and analytical methods (such as segmentation, trend analysis, statistical ... Leverage strong health plan operations knowledge and business acumen to identify and prioritize ...
Health Plan Data Scientist
Long Beach, CA · On-site
Apply data science and analytical methods (such as segmentation, trend analysis, statistical ... Leverage strong health plan operations knowledge and business acumen to identify and prioritize ...
This position ensures that each billing provider is qualified to provide health care services in accordance with Client policies and procedures, The Joint Commission and NCQA standards, commercial ...
This position ensures that each billing provider is qualified to provide health care services in accordance with Client policies and procedures, The Joint Commission and NCQA standards, commercial ...
Health Plan Consultant At Concordia Plans we care for those who serve by providing excellent ... Data Analysis: Ability to securely collect, maintain, research, evaluate, and summarize data for ...
Health Plan Consultant At Concordia Plans we care for those who serve by providing excellent ... Data Analysis: Ability to securely collect, maintain, research, evaluate, and summarize data for ...
Senior Health Plan Pricing Analyst
Dunwoody, GA · On-site +1
$70K - $132K/yr
A Brief Overview The Senior Health Plan Pricing Analyst is responsible for multiple tasks within the department including ensuring the appropriate medical rate is assigned for a prospect. This role ...
Senior Health Plan Pricing Analyst
Dunwoody, GA · On-site +1
$70K - $132K/yr
A Brief Overview The Senior Health Plan Pricing Analyst is responsible for multiple tasks within the department including ensuring the appropriate medical rate is assigned for a prospect. This role ...
Senior Health Plan Pricing Analyst
Dunwoody, GA · On-site
$70K - $132K/yr
A Brief Overview The Senior Health Plan Pricing Analyst is responsible for multiple tasks within the department including ensuring the appropriate medical rate is assigned for a prospect. This role ...
Senior Health Plan Pricing Analyst
Dunwoody, GA · On-site
$70K - $132K/yr
A Brief Overview The Senior Health Plan Pricing Analyst is responsible for multiple tasks within the department including ensuring the appropriate medical rate is assigned for a prospect. This role ...
Senior Health Plan Pricing Analyst
Atlanta, GA · On-site
$70K - $132K/yr
A Brief Overview The Senior Health Plan Pricing Analyst is responsible for multiple tasks within the department including ensuring the appropriate medical rate is assigned for a prospect. This role ...
Senior Health Plan Pricing Analyst
Atlanta, GA · On-site
$70K - $132K/yr
A Brief Overview The Senior Health Plan Pricing Analyst is responsible for multiple tasks within the department including ensuring the appropriate medical rate is assigned for a prospect. This role ...
Health Plan Pharmacist
Huntington Beach, CA · On-site
$61.50 - $74/hr
Health Plan Pharmacist Location: 100% onsite in Huntington Beach, CA. This role requires working in ... Analyze pharmacy utilization, trend, and financial data to identify opportunities for improved ...
Health Plan Pharmacist
Huntington Beach, CA · On-site
$61.50 - $74/hr
Health Plan Pharmacist Location: 100% onsite in Huntington Beach, CA. This role requires working in ... Analyze pharmacy utilization, trend, and financial data to identify opportunities for improved ...
Senior Health Plan Pricing Analyst
$70K - $132K/yr
A Brief Overview The Senior Health Plan Pricing Analyst is responsible for multiple tasks within the department including ensuring the appropriate medical rate is assigned for a prospect. This role ...
Senior Health Plan Pricing Analyst
$70K - $132K/yr
A Brief Overview The Senior Health Plan Pricing Analyst is responsible for multiple tasks within the department including ensuring the appropriate medical rate is assigned for a prospect. This role ...
Senior Health Plan Pricing Analyst
Atlanta, GA · On-site
$70K - $132K/yr
A Brief Overview The Senior Health Plan Pricing Analyst is responsible for multiple tasks within the department including ensuring the appropriate medical rate is assigned for a prospect. This role ...
Senior Health Plan Pricing Analyst
Atlanta, GA · On-site
$70K - $132K/yr
A Brief Overview The Senior Health Plan Pricing Analyst is responsible for multiple tasks within the department including ensuring the appropriate medical rate is assigned for a prospect. This role ...
Sr. Health Plan Operations Analyst
$66K - $79K/yr
The Sr. Analyst, Health Plan Performance (HPP) Ops is responsible for extracting, analyzing, and transforming complex health plan data into actionable strategic insights. This role drives dashboard ...
Sr. Health Plan Operations Analyst
$66K - $79K/yr
The Sr. Analyst, Health Plan Performance (HPP) Ops is responsible for extracting, analyzing, and transforming complex health plan data into actionable strategic insights. This role drives dashboard ...
Health Plan Data Scientist
Long Beach, CA · On-site
Apply data science and analytical methods (such as segmentation, trend analysis, statistical ... Leverage strong health plan operations knowledge and business acumen to identify and prioritize ...
Health Plan Data Scientist
Long Beach, CA · On-site
Apply data science and analytical methods (such as segmentation, trend analysis, statistical ... Leverage strong health plan operations knowledge and business acumen to identify and prioritize ...
Senior Health Plan Pricing Analyst
Dunwoody, GA · On-site
$70K - $132K/yr
A Brief Overview The Senior Health Plan Pricing Analyst is responsible for multiple tasks within the department including ensuring the appropriate medical rate is assigned for a prospect. This role ...
Senior Health Plan Pricing Analyst
Dunwoody, GA · On-site
$70K - $132K/yr
A Brief Overview The Senior Health Plan Pricing Analyst is responsible for multiple tasks within the department including ensuring the appropriate medical rate is assigned for a prospect. This role ...
Senior Health Plan Pricing Analyst
Atlanta, GA · On-site +1
$70K - $132K/yr
A Brief Overview The Senior Health Plan Pricing Analyst is responsible for multiple tasks within the department including ensuring the appropriate medical rate is assigned for a prospect. This role ...
Senior Health Plan Pricing Analyst
Atlanta, GA · On-site +1
$70K - $132K/yr
A Brief Overview The Senior Health Plan Pricing Analyst is responsible for multiple tasks within the department including ensuring the appropriate medical rate is assigned for a prospect. This role ...
Aspirus Health in Wausau, WI is seeking a HEALTHCARE ECONOMICS ANALYST to join our Health Plan team! Healthcare economics analysts are responsible for analyzing large datasets, such as claims and ...
Aspirus Health in Wausau, WI is seeking a HEALTHCARE ECONOMICS ANALYST to join our Health Plan team! Healthcare economics analysts are responsible for analyzing large datasets, such as claims and ...
Sanford Health, the largest rural health system in the United States, is dedicated to transforming ... No Department Details Summary The Account Experience Analyst enhances and elevates the overall ...
Sanford Health, the largest rural health system in the United States, is dedicated to transforming ... No Department Details Summary The Account Experience Analyst enhances and elevates the overall ...
Senior Financial Analyst - Health Plan
Bloomington, MN · On-site
$42.15 - $63.23/hr
HealthPartners is expanding our Finance Department and is seeking a Senior Financial Analyst to support our Health Plan. The Senior Financial Analyst is responsible for a variety of financial ...
Senior Financial Analyst - Health Plan
Bloomington, MN · On-site
$42.15 - $63.23/hr
HealthPartners is expanding our Finance Department and is seeking a Senior Financial Analyst to support our Health Plan. The Senior Financial Analyst is responsible for a variety of financial ...
Sanford Health, the largest rural health system in the United States, is dedicated to transforming ... No Department Details Summary The Account Experience Analyst enhances and elevates the overall ...
Sanford Health, the largest rural health system in the United States, is dedicated to transforming ... No Department Details Summary The Account Experience Analyst enhances and elevates the overall ...
Senior Financial Analyst - Health Plan
Bloomington, MN · On-site
$85K - $107K/yr
HealthPartners is expanding our Finance Department and is seeking a Senior Financial Analyst to support our Health Plan. The Senior Financial Analyst is responsible for a variety of financial ...
Senior Financial Analyst - Health Plan
Bloomington, MN · On-site
$85K - $107K/yr
HealthPartners is expanding our Finance Department and is seeking a Senior Financial Analyst to support our Health Plan. The Senior Financial Analyst is responsible for a variety of financial ...
The Financial Analyst is a professional role and must demonstrate the ability to manage competing ... health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan ...
The Financial Analyst is a professional role and must demonstrate the ability to manage competing ... health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan ...
Health Plan Analyst information
What is a health plan analyst?
Health Plan Analysts are professionals who evaluate, design, and manage health insurance plans for organizations or insurance companies. They analyze data related to healthcare costs, utilization, and plan performance to ensure that health plans are cost-effective and compliant with regulations. Their work often involves collaborating with actuaries, benefits managers, and healthcare providers to optimize plan offerings and improve member satisfaction. Health Plan Analysts also help identify trends, forecast future needs, and recommend changes to existing plans based on their analysis.
What are the key skills and qualifications needed to thrive as a health plan analyst, and why are they important?
To thrive as a Health Plan Analyst, you need strong analytical skills, knowledge of healthcare regulations, and a background in statistics, economics, or public health, often supported by a relevant bachelor’s degree. Familiarity with data analysis tools such as Excel, SQL, and healthcare-specific software like SAS or Tableau, as well as understanding HIPAA compliance, is typically required. Excellent communication, problem-solving, and attention to detail help analysts interpret data and convey insights to stakeholders. These skills are vital for optimizing health plan performance, ensuring regulatory compliance, and supporting data-driven decision-making in healthcare organizations.
What are some common challenges health plan analysts face when interpreting healthcare data, and how can they overcome them?
Health Plan Analysts often encounter challenges such as inconsistent data sources, complex regulatory requirements, and rapidly changing healthcare policies. To overcome these, analysts must develop strong analytical skills, stay current with industry guidelines, and maintain close collaboration with cross-functional teams like IT, compliance, and clinical departments. Leveraging data visualization tools and ongoing professional development can also help ensure accurate analysis and effective communication of findings.
What cities are hiring for Health Plan Analyst jobs?
Cities with the most Health Plan Analyst job openings:
What states have the most Health Plan Analyst jobs?
States with the most job openings for Health Plan Analyst jobs include:
What are popular job titles related to Health Plan Analyst jobs?
For Health Plan Analyst jobs, the most frequently searched job titles are:
Medical Economics Analyst, Health Plan
Marshfield, WI • On-site
Sanford Health
• Health Care and Social Assistance • 10K+ employees10,000+ employees
Full-time
Posted 24 days ago
Sanford Health rating
6.7
Based on 561 frontline employees who took The Breakroom Quiz
Job description
Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America's heartland.
Work Shift:
8 Hours - Day Shifts (United States of America)
Scheduled Weekly Hours:
40
Compensation:
Salary Range: $29.00 - $46.50
Union Position:
No
Department Details
Summary
The Medical Health Economics Analyst uses data analysis to identify medical cost trends, evaluate financial performance, and provide actionable insights to support strategic business decisions. This role is vital for cost containment and improving plan performance.
Job Description
Analyze complex medical claims, pharmacy data, and other healthcare data sets to identify emerging cost and utilization trends, patterns, and outliers. Develop financial models to evaluate the financial impact of new clinical programs, new initiatives, and value-based agreements. Identify opportunities for medical cost reduction, quantify potential savings, and measure the return on investment (ROI) of implemented initiatives. Create clear, concise reports, dashboards, and presentations using data visualization tools to communicate complex findings and actionable insights to a variety of stakeholders, including senior management and clinical departments. Work closely with accounting, actuarial, underwriting, clinical, health services delivery and network management teams to provide analytical support for decision-making and strategic planning, such as informing payer negotiations and risk adjustment strategies. Ensure the accuracy and integrity of data used in analyses, and prepare well-organized project documentation including methodologies and key decision points. Respond to ad-hoc data analysis requests from various departments, providing timely intelligence related to specific business problems.
Qualifications
Bachelor's degree in Economics, Statistics, Finance, Public Health, Mathematics, Actuarial Science, Data Analytics or related quantitative discipline required.
1-3 years of progressive analytical experience in a healthcare setting (health insurance, managed care, or health system) is required.
Knowledge of STARs and Risk Adjustment preferred.
Strong analytical, problem-solving, critical thinking, and communication skills are vital for success in this role.
Proficiency in SQL for data extraction and manipulation is a must.
Advanced Microsoft Excel skills, including pivot tables and complex formulas, are essential.
Experience with data visualization tools like Tableau or Power BI is highly valued. Familiarity with statistical tools such as SAS, R, or Python is often a plus.
Sanford is an EEO/AA Employer M/F/Disability/Vet.
If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-949-5678 or send an email to talent@sanfordhealth.org.
Work Shift:
8 Hours - Day Shifts (United States of America)
Scheduled Weekly Hours:
40
Compensation:
Salary Range: $29.00 - $46.50
Union Position:
No
Department Details
Summary
The Medical Health Economics Analyst uses data analysis to identify medical cost trends, evaluate financial performance, and provide actionable insights to support strategic business decisions. This role is vital for cost containment and improving plan performance.
Job Description
Analyze complex medical claims, pharmacy data, and other healthcare data sets to identify emerging cost and utilization trends, patterns, and outliers. Develop financial models to evaluate the financial impact of new clinical programs, new initiatives, and value-based agreements. Identify opportunities for medical cost reduction, quantify potential savings, and measure the return on investment (ROI) of implemented initiatives. Create clear, concise reports, dashboards, and presentations using data visualization tools to communicate complex findings and actionable insights to a variety of stakeholders, including senior management and clinical departments. Work closely with accounting, actuarial, underwriting, clinical, health services delivery and network management teams to provide analytical support for decision-making and strategic planning, such as informing payer negotiations and risk adjustment strategies. Ensure the accuracy and integrity of data used in analyses, and prepare well-organized project documentation including methodologies and key decision points. Respond to ad-hoc data analysis requests from various departments, providing timely intelligence related to specific business problems.
Qualifications
Bachelor's degree in Economics, Statistics, Finance, Public Health, Mathematics, Actuarial Science, Data Analytics or related quantitative discipline required.
1-3 years of progressive analytical experience in a healthcare setting (health insurance, managed care, or health system) is required.
Knowledge of STARs and Risk Adjustment preferred.
Strong analytical, problem-solving, critical thinking, and communication skills are vital for success in this role.
Proficiency in SQL for data extraction and manipulation is a must.
Advanced Microsoft Excel skills, including pivot tables and complex formulas, are essential.
Experience with data visualization tools like Tableau or Power BI is highly valued. Familiarity with statistical tools such as SAS, R, or Python is often a plus.
Sanford is an EEO/AA Employer M/F/Disability/Vet.
If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-949-5678 or send an email to talent@sanfordhealth.org.
What Sanford Health employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Sanford Health
Sourced by ZipRecruiter
Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.
Industry
Health care and social assistance and hospitals
Company size
10,000+ Employees
Headquarters location
Sioux Falls, SD, US