A rapidly growing insurtech is looking to hire an experienced Medical Economics Consultant to join their Medicare Advantage team. This position will work closely with multiple areas of the business, including the actuarial team and executive leadership.
The Medical Economics Consultant role has the option to be worked remotely from anywhere in the United States
Responsibilities of Medical Economics Consultant:
- Provide expertise to advance capabilities in provider contracting, clinical program assessment, population health, payment integrity, provider reimbursement, and financial performance management.
- Work with the Claims Payment Integrity team to ensure timely and accurate claims payments
- Work with the network team to understand and quantify reimbursement terms
- Consult and advise on provider and facility reimbursement strategy.
Qualifications of Medical Economics Consultant:
- 7+ years of experience in healthcare
- Significant experience with Medicare Advantage
- Broad understanding of managed care business and financial principles such as underwriting, risk adjustment, medical management, physician reimbursement, and risk management