Milliman Care Guidelines

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Healthcare Claims Research Analyst

at Milliman Care Guidelines

Posted: 7/30/2019
Job Status: Full Time
Job Reference #: ca7666b0-9ee1-4f8d-81ae-013561f1aa26

Job Description

Do you have the analytic skills to find insight in a pile of healthcare data? Do you thrive in a fast-paced environment? Milliman’s NYC Health Practice is seeking professionals from a variety of analytic and clinical backgrounds to join our vibrant staff. We offer challenging projects, world-class resources, expert colleagues, a collaborative environment, and diverse client projects. Work, learn, and grow with us.

Milliman’s NYC Health Practice consults to clients including treatments and costs in different populations, healthcare reform, financial risk, and payer systems. Our clients span all sectors of the health industry. Our services include analyzing financial arrangements, innovative contracts, disease states, therapeutic value of treatments, benefit design, healthcare reform, and health systems. We have brought unparalleled actuarial, analytical, and operational expertise to these clients. We have hundreds of publications.

Milliman is the world’s premier actuarial consulting firm with over 3,000 employees and $1 billion in revenue. We attribute our 70 years of continuous growth to our environment where independent and talented individuals succeed as outstanding professionals. We have a collegial, rigorous, supportive and non-bureaucratic environment.

We seek energetic and imaginative professionals to join our client-oriented team at our Penn Station, New York City location. Successful candidates will have the potential to become project/client leaders and become recognized as expert senior consultants.

Primary roles

  • Conduct literature reviews of analyses of disease conditions and patterns of treatment
  • Develop methodologies for detailed claims-based studies, including coding algorithms, to generate real world evidence and data analytics
  • Design innovative techniques for using large claims datasets to analyze a wide array of healthcare-related topics
  • Investigate differences in expected versus observed disease-related diagnoses and services in claims datasets
  • Contribute to hypothesis development for quasi-experimental designs
  • Assist colleagues with understanding how to use health insurance claims to answer questions
  • Role in project and client management that will increase over time

Qualifications:

  • Required:
    • At least three years of experience contributing to the analysis of large medical insurance claims databases
    • Advanced understanding of medical coding systems (CPT/HCPCS, ICD-9 and 10, DRG, etc.)
    • New York City location; this job requires working with colleagues in our office
    • Limited travel—working at client site is rare
    • Knack for prioritizing and completing multiple projects and tasks
    • Strong oral and written communication skills
    • Strong problem solving and analytical skills
    • Ability to work both independently and as part of a team
    • Experience or knowledge of the healthcare industry and payer systems
  • Preferred:
    • Experience in insurance, finance, or outcomes research
    • Experience with MarketScan and/or Medicare (or similar) databases
    • PharmD, RN, MD, MPH, MS, PhD, or similar background